Private Health Insurance (Prostheses) Rules 2016 (No. 1) (Cth)
I, Tracey Duffy, delegate of the Minister for Health, make these Rules under item 4 of the table in section 333-20 of the
3 March 2016
Tracey Duffy
Tracey Duffy
Assistant Secretary
Medical Benefits Division
Department of Health
These Rules are the
Private Health Insurance (Prostheses) Rules 20 16 (No. 1) .
(1) These Rules commence on 25 March 2016.
(2) These Rules are made under item 4 of the table in section 333-20 of the
Private Health Insurance Act 2007 .
These Rules revoke the
Private Health Insurance (Prostheses) Rules 2015 (No. 2) .
In these Rules:
accredited podiatrist means a podiatric surgeon who holds specialist registration in the specialty of podiatric surgery under the National Law.Note: The registration requirements for an accredited podiatrist for the purposes of these Rules are the same registration requirements for podiatric surgeons as set out in rule 8 of the Private Health Insurance (Accreditation) Rules.
Act means thePrivate Health Insurance Act 2007 .
cardiac home/remote monitoring system includes a component of a cardiac home/remote monitoring system.
certified overnight Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.
certified Type C procedure has the same meaning as in rule 3 of the Private Health Insurance (Benefit Requirements) Rules.
consultant physician has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973.
gap permitted prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and a different amount is set out in the column under the heading 'Maximum Benefit'.
implantable cardiac event recorder includes a component of an implantable cardiac event recorder.
insulin infusion pump includes a component of an insulin infusion pump.
listed prosthesis means a kind of prosthesis listed in the Schedule to these Rules.
listing application has the same meaning as in subsection 72-10(6) of the Act.
listing criteria has the same meaning as in subsection 72-10(6) of the Act.
National Law means:(a) for a State or Territory other than Western Australia — the Health Practitioner Regulation National Law set out in the Schedule to the
Health Practitioner Regulation National Law Act 2009 (Qld)as it applies (with or without modification) as law of the State or Territory; or(b) for Western Australia — the legislation enacted by the
Health Practitioner Regulation National Law (WA) Act 2010 that corresponds to the Health Practitioner Regulation National Law.Note: The Intergovernmental Agreement for a National Registration and Accreditation Scheme for the Health Professions that was made on 26 March 2008 provides for the enactment of the State and Territory legislation mentioned in this definition.
no gap prosthesis means a prosthesis of a kind listed in the Schedule where an amount is set out for that kind of prosthesis in the column under the heading 'Minimum Benefit' and no amount is set out in the column under the heading 'Maximum Benefit'.
private hospital means a hospital in respect of which there is in force a statement under subsection 121-5(8) of the Act that the hospital is a private hospital.
professional attendance has the same meaning as in clause 1.2.3 of the general medical services table being the table prescribed under section 4 of theHealth Insurance Act 1973 .
professional service has the same meaning as in subsection 3(1) of theHealth Insurance Act 1973 .
public hospital means a hospital in respect of which there is in force a statement under subsection 121-5(8) of the Act that the hospital is a public hospital.
Schedule means the Schedule in these Rules.Note: Terms used in these Rules have the same meaning as in the Act―see section 13 of the
Legislation Act 2003 . These terms include:complying health insurance policy
hospital-substitute treatment
hospital treatment
medicare benefit
For item 4 of the table in subsection 72-1(2) of the Act:
(a) the Schedule lists the kinds of prostheses:
(i) in relation to which the Minister has granted an application for listing under subsection 72-10(5) of the Act; or
(ii) which are listed in accordance with section 12 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 ; andNote: Section 12 of the
Private Health Insurance (Transitional Provisions and Consequential Amendments) Act 2007 deals with the listing of a prosthesis that was a no gap prosthesis or a gap permitted prosthesis for the purposes of theNational Health Act 1953 immediately before the commencement of the Act.(aa) circumstances in which a listed prosthesis is provided for the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5A; and
(ab) conditions that must be satisfied in relation to the provision of a listed prosthesis for the purposes of paragraphs (c) and (d) of item 4 of the table in subsection 72-1(2) are set out in rule 5B; and
(b) rule 6 sets out the method for working out the minimum benefit and maximum benefit for hospital treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis; and
(c) rule 7 sets out the method for working out the minimum benefit and maximum benefit for hospital-substitute treatment, covered under a complying private health insurance policy, that is the provision of a listed prosthesis.
For the purposes of paragraph (d) of item 4 of the table in subsection 72-1(2) of the Act, the following circumstances are set out:
(a) the provision of a listed prosthesis which is associated with podiatric treatment by an accredited podiatrist.
Note: Paragraph (c) of Item 4 of subsection 72-1(2) deals with the provision of a listed prosthesis in circumstances in which a medicare benefit is payable.
For the purposes of paragraphs (c) and (d) of item 4 of the table in subsection
72-1(2) of the Act, conditions that must be satisfied in relation to the provision of a listed prosthesis in the circumstances covered by paragraph (c) or (d) of that item, as the case may be, are:
(a) in relation to any kind of prosthesis where there is a statement of a requirement under the heading 'Condition' in the Schedule under the listing for that kind of prosthesis, that requirement; and
(b) in relation to a listed prosthesis that is an insulin infusion pump, also:
(i) the professional service associated with the provision of the insulin infusion pump must be a professional attendance by a consultant physician in the practice of his or her specialty; and
(ii) the professional service must be provided as a certified Type C procedure or certified overnight Type C procedure; and
(iii) the insulin infusion pump must be provided for the purpose of administering insulin.
Note: Item 4 of the table in subsection 72-1(2) of the Act states other requirements in relation to benefits for the provision of prostheses that a policy that covers hospital treatment must meet. These requirements relate to benefits for hospital treatment and, if the policy covers hospital-substitute treatment, to the benefits of that coverage as well.
(1) For a no gap prosthesis provided as part of an episode of hospital treatment in a private hospital, the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.
(2) For a gap permitted prosthesis provided as part of an episode of hospital treatment in a private hospital:
(a) the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and
(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.
(3) For a no gap prosthesis provided as part of an episode of hospital treatment in a public hospital:
(a) the minimum benefit is the lesser of the following amounts:
(i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or
(ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and
(b) the maximum benefit is the amount for that prosthesis listed in the column under the heading 'Minimum Benefit' in the Schedule.
(4) For a gap permitted prosthesis provided as part of an episode of hospital treatment in a public hospital:
(a) the minimum benefit is the lesser of the following amounts:
(i) the amount for that prosthesis listed in the column under the heading ‘Minimum Benefit’ in the Schedule; or
(ii) the amount of the insured person’s liability to the public hospital for that prosthesis; and
(b) the maximum benefit is the amount for that prosthesis listed in the column under the heading ‘Maximum Benefit’ in the Schedule.
Note: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.
(1) For a no gap prosthesis provided as part of an episode of hospital-substitute treatment the minimum benefit and the maximum benefit are each the amount for that prosthesis listed in the column in the Schedule under the heading ‘Minimum Benefit’.
(2) For a gap permitted prosthesis provided as part of an episode of hospital-substitute treatment:
(a) the minimum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Minimum Benefit’; and
(b) the maximum benefit is the amount for that prosthesis in the column in the Schedule under the heading ‘Maximum Benefit’.
Note 1: Private health insurers cannot cover, as part of hospital-substitute treatment, a service for which medicare benefit is payable unless the service is specified in the
Private Health Insurance (Health Insurance Business) Rules ― see subsection 121-10(3)(a) of the Act.Note 2: Paragraphs (d) and (e) of subsection 72-10(5) of the Act deal with the fixing of minimum and maximum benefits when the Minister is making or varying the Private Health Insurance (Prostheses) Rules.
As a matter of normal administrative practice, applications made under subsection 72-10(2) of the Act will be considered after they have been received and, if the Minister decides to grant the application, the kind of prosthesis will be listed in the Schedule the next time the Minister makes or varies the Rules.
Note 1: Under subsection 72-10(5) of the Act the Minister must list the kind of prosthesis, set out the minimum benefit and, if the Minister considers it appropriate, the maximum benefit for the prosthesis in these Rules on the next occasion that the Minister makes or varies the Rules after he or she grants an application and the applicant has paid to the Commonwealth any initial listing fee within 14 days of being informed of the Minister's decision to grant the application.
Note 2: Under subsection 72-15(3) of the Act, the Minister may remove a kind of prosthesis from the list in the Rules if the applicant fails to pay an ongoing listing fee.
In making the decision under subsection 72-10 of the Act, the Minister may have regard to a recommendation from the Prostheses List Advisory Committee.
For a listing application to be granted to list a kind of prosthesis in Part C of the Schedule, the listing criterion is that the kind of prosthesis is an:
(i) insulin infusion pump;
(ii) implantable cardiac event recorder; or
(iii) cardiac home/remote monitoring system.
Note 1: The power to make listing criteria is in subsection 72-10(6) of the Act.
Note 2: Under subsection 72-10(7) of the Act the Minister must not grant a listing application if any applicable listing criteria are not satisfied in relation to the application.
Note 3: Under the Act the Minister may refuse to grant a listing application even if the listing criteria are satisfied. See Note to subsection 72-10(7) of the Act.
Part A - Prostheses List February 2016
AL003 MTA2UO - MTA6UO PMMA +5 to +30 D $156.00
BL005 Storz (Coburn) Intraocular Lens PMMA Anterior Chamber Intraocular lens 1 13.75mm length. 6.0mm optic size, diopter $156.00
121UV; L122UV PMMA Anterior piece range 3-30d. L122UV: 6.0mm optic,
Chamber Lens 13.75mm length, power range; 5.0 to 30.0
AO019 Verisyse AC IOL Aphakic Model 5mm Optic Diameter x 8.5 overall length $250.00
EG009 Artisan Anterior Chamber Aphakia ModelComposition: PMMA 5.00mm Optic Diameter x 8.5 in overall length $250.00
Intraocular Lens
AO001 Intraocular Lens: Model AC 51L Duralens PMMA, Anterior Chamber IOL 6.00 mm Optic Diameter x 13.0mm in overall $198.00
length
AO016 Verisyse AC IOL Phakic Intraocular Lens: Model Myopia. 5mm Optic Diameter x 8.5 overall length; $680.00
Composition: PMMA 6mm Optic Diameter x 8.5 overall length
AO017 Verisyse AC IOL Phakic Intraocular Lens: Model Hyperopia. 5mm Optic Diameter x 8.5 overall length $680.00
Composition: PMMA
EG012 Artisan Anterior Chamber IOL Phakic Intraocular Lens Myopic / Hyperopic 5.00mm Optic Diameter x 8.5 in overall $680.00
Prostheses List by Category, Groups and Sponsor Page 1 of 973
AO030 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x 7.5mm overall length $1,056.00
EG019 Artisan Toric (Custom) T1 AC Iris clip IOL Toric 5.00mm Optic Diameter x 7.5 Overall $1,150.00
AO029 Verisyse Toric (Custom) Phakic intraocular lens: Model toric 5mm Optic Diameter x 7.5mm overall length $1,358.00
EG020 Artisan Toric (Custom) T2 AC Iris clip IOL Toric 5.00mm Optic Diameter x 7.5 Overall $1,452.00
AO025 VeriFlex Foldable Phakic IOL Anterior chamber foldable phakic silicone -2 to -14.5d in 0.5d increments. Overall $723.00
intraocular lens diameter 8.5mm. Optic 6.0mm
EG010 Artiflex Anterior Chamber Optic: Hydrophobic Polysiloxane. Haptic: 6mm optic diameter x 8.5 in overall length $723.00
Intraocular Lens PMMA
AL002 Models MZ60BD, MC50BD, CZ70BD Other:PMMA Range of Powers:-10 to +34 D $156.00
CZ040 CT SPHERIS 209M Micro incision, Spherical aberrated, foldable Diopter range :0.00 to + 32.0. Optic Size: $322.00
square-edged single-piece intraocular lens for 6mm Overall Length: 11mm
capsular bag fixation.
Prostheses List by Category, Groups and Sponsor Page 2 of 973
CZ016 CT ASPHINA 409M ZEISS Micro Incision Aspheric (aberration 6mm optic, 11mm overall diameter. Diopter $364.00
neutral) IOL: Foldable, square-edged, single range 0.0 to +32.0D (0.5D steps from 10.0 to
piece IOL for capsular bag fixation 30.0D, 1.0D outside this range)
CZ017 CT ASPHINA 509M ZEISS Micro Incision Aspheric (aberration 6mm Optic, 11mm overall diameter. Diopter $364.00
correcting) IOL: Foldable, square-edged, range 0.0 to +32.0D (0.5D steps from 10.0 to
single piece IOL for capsular bag fixation 30.0D, 1.0D outside this range)
BL026 Akreos AO Micro Incision Lens Micro Incision, posterior chamber, foldable 6mm optic overall diameter 11.0mm(10D- $374.00
acrylic, aphakic, anterior & posterior edge 15D), 10.7mm (15.50-22D), 10.5mm (22.50-
modification, preloaded, with aberration 30D)
control, intraocular lens
CZ028 CT ASPHINA 409MP Preloaded, micro incision, aspheric Diopter range: 0.0 to 32.0D; Optic size: $374.00
(aberration neutral), foldable square-edged 6.0mm; Overall length: 11.0mm
single piece intraocular lens for capsular bag
CZ037 CT ASPHINA 509MP Preloaded, micro incision, aspheric Diopter range: 0.0 to + 32.0D; Optic Size: $374.00
(aberration correcting), foldable square-edged 6.0mm; Overall length: 11.0mm
single-piece intraocular lens for capsular bag
DV263 Rayner C-flex Advance Aspheric Mini incision pre-loaded aspheric IOL Power range +8.0 - +34.0 dioptres in 0.5 $374.00
increments
EG016 ARTIS PL E Preloaded Intraocular lens 0 to 35D $374.00
EG017 LUXIOL 60 Preloaded Intraocular lens +10 to +35D $374.00
KG015 Rayner C-flex Advance Aspheric Mini incision pre-loaded aspheric IOL Power range +8.0 - +34.0 dioptres in 0.5 $374.00
increments
CZ031 AT TORBI 709MP (Standard Bitoric, preloaded, micro incision, aspheric Diopter range: Sph -10.0 to 32.0, Cyl +1.0 to $760.00
(aberration neutral), foldable, square-edged, 6.5
single-piece IOL for capsular bag fixation Optic size: 6.0mm, Overall length: 11.0mm
Prostheses List by Category, Groups and Sponsor Page 3 of 973
EG015 ARTIS T PL Preloaded Toric Intraocular lens +18 to +25D / C +1.50D $760.00
CZ032 AT TORBI 709MP (high cyl) Bitoric, preloaded, micro incision, aspheric Diopter range: Sph -10.0 to 32.0, Cyl +7.0 to $1,061.00
(aberration neutral), foldable, square-edged, 12.0, Optic size: 6.0mm. Overall Length
single-piece IOL for capsular bag fixation 11.0mm
IS017 Preloaded Monofocal Hydrophilic Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $405.00
677PY with Blue light Filter for Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
Medjet PL-MA 2.2 single use Powers available:
injection system -10.0 - +9.0 D ±0.25 D increment: 1.0 D
+10.0 - +25.0 D ±0.25 D increment: 0.5 D
+25.5 - +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +45.0 D ±0.5 increment: 1.0 D
CZ020 AT TORBI 709M STANDARD RANGE BITORIC - ZEISS 6mm optic, 11mm overall diameter. Diopter $740.00
Micro Incision Aspheric (abberation neutral) range: Sph -10.0 to +32.0D, Cyl +1.0 to
IOL: Foldable, square-edged, single piece 6.5D (all 0.5D steps)
IOL for capsular bag fixation
CZ027 AT TORBI 709M HIGH CYLINDER BITORIC - ZEISS Micro 6mm optic, 11mm overall diameter. Diopter $1,041.00
Incision Aspheric (aberration neutral) IOL: range: Sph -10.0 to +32.0D, +7.0 to 12.0D
Foldable square edged, single piece IOL for (all 0.5D steps)
capsular bag fixation
XE002 Staar foldable silicone intraocular Polyimide haptics 6.3mm optic - low diopters 14.0mm length $281.00
lens: Model AQ 5010V
Prostheses List by Category, Groups and Sponsor Page 4 of 973
AL004 Acrysof Multipiece Models Foldable Acrylic Multi-piece Lens -5 D to +30 D $322.00
MA50BM, MA60AC
AL011 Acrysof Model SA60AT Foldable Acrylic Single-piece Lens, Range of Powers: +6 to +40 D $322.00
asymmetric optic/consistent edge
AO002 Sensar AR40 Monofocal Acrylic Soft Acrylic, Foldable, UV Absorbing, Range available from -10D to +30D. 6 mm $322.00
Sensar OptiEdge AR40e Optic Diameter x 13mm in overall length.
Foldable Acrylic IOL
CZ029 CT 53N Foldable, 3-piece, monofocal, square-edged, Diopter range: 0.0 to 40.0, Optic size: $322.00
hydrophilic acrylic (with hydrophobic 6.0mm, Overall length: 13.0mm
surface properties) intraocular lens for
capsular bag or sulcus fixation.
DE398 Oculentis LENTIS L-302-1 Foldable one-piece monofocal C loop acrylic Optic Size 6.0mm, Overall Length 12.00mm. $322.00
IOL. +-0.0D to +35.0D (1.0D steps) and +15.5D
to +26.5D (0.5D steps).
XE003 Staar foldable silicone IOLs: Plate haptics 6.0mm; Polymide haptics 5.5 or 10.8mm 0 13.5mm length $322.00
Models AQ2010V, AQ2017V and 6.3mm optic;
KG001 Rayner C-Flex Hydrophilic HEMA-MMA copolymer, 5.75mm dia optic, 12.00mm dia overall $322.00
foldable with injector
KG002 Superflex Hydrophilic HEMA-MMA copolymer, 6.25mm dia optic, 12.5mm dia overall $322.00
foldable with injector
LN007 Tecsoft Flex Single piece square edged foldable intraocular Diopter power range: +5.0 D to +32.0D (0.5 $322.00
lens for implantation into the capsular bag. D increments from +10.0 D to +30.0 D, 1.0 D
increments outside this range).
For powers +5.0 D to +17.5D - Optic size:
6.0mm. Overall Length 13.5mm.
For powers +18.0 D to +25.5D - Optic size:
5.9mm. Overall Length 13.0mm.
For powers +26.0 D to +32.0 D - Optic size:
5.8mm. Overall Length 12.5mm.
Prostheses List by Category, Groups and Sponsor Page 5 of 973
AL038 Acrysof Aspheric UV-absorbing Foldable Acrylic Single-piece Lens with UV + 6.0 D to +30.0 D $364.00
Absorbing and Aspheric Correction
AO014 TECNIS® Intraocular Lens (Z9002 Foldable Intraocular Lenses - Ultraviolet 5-10 dioptre in 1.0 dioptre increments; 10.5 $364.00
& ZA9003) light absorbing posterior chamber intraocular - 30 dioptre in 0.5 increments
lenses, Silicone/Acrylic
AO024 Tecnis® One Piece (ZCB00) One piece intraocular lens with edge +5 to +34 diopter powers in 0.5d increments. $364.00
modification and 360 degree square edge Overall diameter 13mm, Optic size 6mm
BL022 SofPort Advanced Optic (AO) Posterior chamber, foldable silicone IOL with 0 D to 30.0 D $364.00
anterior optic-haptic square edge, posterior
optic-haptic square edge, 360-degree optic
square edge and asperic optic for aberration
control
BL023 Akreos Advanced Optic Posterior chamber, foldable acrylic IOL, with 0 D to 30.0 D $364.00
anterior optic-haptic square edge, posterior
optic-haptic square edge, 360 degree optic
square edge and aspheric optic for aberration
control
BL030 enVista The enVista, Model MX60, is an ultra-violet- Overall diameter 12.5mm, optic body $364.00
absorbing, posterior chamber, hydrophobic diameter 6.0mm in dioptric powers ranging
acrylic one-piece foldable intraocular lens from +0.0 to +34D
Has an aspheric lens optic, square 0.0D to 10.0D in 1 Diopter increments
posterior edge, modified C haptics and 11.0D to 30.0D in 0.5 Diopter increments
available in dioptric powers ranging from 31.0D to 34.0D in 1 Diopter increments
+0.0 to +34.0D.
CZ030 CT ASPHINA 404 Small incision, foldable, single piece, Diopter range: -10.0 to 42.0, Optic size: $364.00
monofocal, aspheric (aberration neutral), 6.0mm, Overall length: 11.0mm
square-edged, hydrophilic acrylic (with
hydrophobic surface properties) intraocular
lens for capsular bag fixation. (Monofocal lens
for powers outside standard 409MP MICS
Prostheses List by Category, Groups and Sponsor Page 6 of 973
DE399 Oculentis LENTIS L-312 Foldable one-piece monofocal acrylic C Loop Optic size 6.0mm, Overall Length 12.00mm. $364.00
IOL Central Thickness 1.02mm (+22.0D).
Available Diopters: -10.0D to35.0D (1.0D
steps). +10.5D to 29.5D (0.5D steps)
DE400 Oculentis LENTIS L-313 Foldable one-piece monofocal acrylic plate Optic size 6.0mm, Overall Length 11.00mm. $364.00
IOL Available Diopters: +-0.0D to 35.0D (1.0D
steps). +10.5D to 29.5D (0.5D steps)
DE401 Oculentis LENTIS L-402 Foldable three piece monofocal acrylic IOL. Optic Size 6.0mm, Overall Length 13.00mm. $364.00
+-0.0D to +35.0D (1.0D) + 15.5D to +26.5D
(0.5D). Minus range on demand.
IS010 BiFlex 677AB Hydrophilic Acrylic Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $364.00
Foldable Aspheric Monofocal Lens Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
(without Blue light Filter) Powers available:
-10.0 - +9.0 D ±0.25 D increment: 1.0 D
+10.0 - +25.0 D ±0.25 D increment: 0.5 D
+25.5 - +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +45.0 D ±0. D increment: 1.0 D
IS035 BiFlex 877FAB Hydrophobic Posterior Chamber IOL, special 360° sharp Optic diameter: 6.0 mm ±0.10 mm, Overall $364.00
Acrylic Foldable Aspheric edge, Aspheric - Aberration Balanced diameter: 13.0 mm ±0.20 mm
Monofocal Lens without Blue light Powers available:
-0.0 - +9.0 D ±0.25 D increment: 1.0 D
+10.0 - +25.0 D ±0.25 D increment: 0.5 D
+25.5 - +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +35.0 D ±0.5 D increment: 1.0 D
IQ004 Softec Acrylic, single piece, foldable intraocular lens Available in dioptric powers from -5.0 to $364.00
with anterior and posterior optic-haptic +36.0, 1D steps: -5.0 to +10.0 and +31.0 to
square edge, 360 degree optic square edge +36.0; 0.5D steps: +10.5 to +18.0 and +25.0
design, precision power calculation and to +29.5; 0.25D steps: +18.0 to +25.0
aberration technology
IQ013 PreciSAL 302AC Acrylic, single piece, foldable intraocular lens Available in dioptric powers from 0.0 to $364.00
with anterior and posterior optic-haptic +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:
square edge, 360 degree optic square edge +10.5 to + 17.5 and +28.5 to +30.0; 0.25D
design, precision power calculation, steps: +18.0 to +28.0
aberration technology and UV light filter.
Prostheses List by Category, Groups and Sponsor Page 7 of 973
KG012 Rayner "C-Flex" and Superflex" Aspheric Intra Ocular Lenses with Amon- C-Flex -970C + 22.5D to +34D Superflex- $364.00
Aspheric IOL Apple enhanced 360 Degree square edge, 920H - 10D to +22D
Anti-vaulting Haptics
LN003 ALSAFIT Single piece aspheric foldable intraocular lens Diopter power range: 0.0 D to 32.00 D (0.50 $364.00
for implantation into the capsular bag. D increments). Optic size: 6mm. Overall
length: 11.0mm.
SO074 HumanOptics Aspira Posterior chamber IOL, foldable, UV absorber, -6.0 to +40.0 D $364.00
Aspheric, aberration technology, 360° LEC
barrier, HD optic
AO034 TECNIS® iTec 1-Piece Pre-Loaded 1-piece IOL Posterior Chamber Intraocular +5.0 to +34.0 diopter powers in 0.5 diopter $374.00
IOL lens, incorporates a proprietary wavefront- increments. Overall diameter 13mm, Optic
designed aspheric optic with a squared size 6mm
posterior optic edge designed to provide a
360 degree barrier. The edge of the optic has a
frosted design to reduce potential edge glare
effects. Supplied pre-loaded in a screw style
disposable injector.
XE004 Preloaded Aspheric Intraocular Silicone intraocular lens 6.0mm $374.00
IS031 Medicontur Preloaded Monofocal Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $374.00
Hydrophilic 677P without Blue Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
light Filter for Medjet PL-MA 2.2 Powers available:
single use injection system -10.0 - +9.0 D ±0.25 D increment: 1.0 D
+10.0 - +25.0 D ±0.25 D increment: 0.5 D
+25.5 - +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +45.0 D ±0.5 D increment: 1.0 D
IS032 Medicontur Preloaded Monofocal Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $374.00
Hydrophilic 640P without Blue Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
light Filter for Medjet PL-MA 2.2 Powers available:
single use injection system -10.0 - +9.0 D ±0.25 D increment: 1.0 D
+10.0 - +25.0 D ±0.25 D increment: 0.5 D
+25.5 - +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +45.0 D ±0.5 D increment: 1.0 D
Prostheses List by Category, Groups and Sponsor Page 8 of 973
IS036 BiFlex 877PA Preloaded Posterior Chamber IOL, special 360° sharp Optic diameter: 6.0 mm ±0.10 mm, Overall $374.00
Hydrophobic Acrylic Foldable edge, Aspheric Aberration Balanced diameter: 13.0 mm ±0.20 mm
Aspheric Monofocal Lens without Powers available:
Blue Light Filter -0.0 - +9.0 D ±0.25 D increment: 1.0 D
+10.0 - +25.0 D ±0.25 D increment: 0.5 D
+25.5 - +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +35.0 D ±0.5 D increment: 1.0 D
IQ014 PreciSAL P302AC Preloaded Acrylic, single piece, foldable Available in dioptric powers from 0.0 to $374.00
intraocular lens with anterior and posterior +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:
optic-haptic square edge, 360 degree optic +10.5 to + 17.5 and +28.5 to +30.0; 0.25D
square edge design, precision power steps: +18.0 to +28.0
calculation, aberration technology and UV
light filter.
SO075 HumanOptics Aspira Preloaded Preloaded posterior chamber IOL, foldable, +10.0 to +40.0 D $374.00
UV absorber, Aspheric, aberration
technology, 360° LEC barrier, HD optic
BL032 enVista Toric The enVista toric (Model MX60T) is a one- Overall diameter is 12.5mm for the entire lens $760.00
piece glistening-free hydrophobic foldable power range, with spherical equivalent
IOL. The enVista Toric, model MX60T IOL powers from +6.0 to +30.0 Diopters in 0.5
has a Toric aspheric lens optic, a square Diopter steps and cylinder powers from +1D
posterior edge and modified C haptics, an to 6D Diopters (at the IOL plane).
overall diameter of 12.5mm and an optic body
It is available in multiple spherical
and cylindrical powers.
IS026 Medicontur BiFlex 677PT Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $760.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens without Blue light Filter, Aspheric – Coma optimized – Toric Powers available:
Preloaded -10.0 - +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
Prostheses List by Category, Groups and Sponsor Page 9 of 973
IQ017 PreciSAL Toric T302AC Acrylic single piece, foldable intraocular lens Available in spherical dioptric powers from $760.00
with anterior and posterior optic-haptic 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D
square edge, 360 degree optic square edge steps: +10.5 to +17.5 and +28.5 to +30.0;
design, precision power calculation, 0.25D steps: +18.0 to +28.0; Cylinder
aberration technology, toric correction on powers from 1.0D to 6.0D
anterior surface with cylinder marks to
indicate flat meridian plus the cylinder axis to
allow alignment for astigmatic correction, and
UV filter.
IQ018 PreciSAL Toric PT302AC Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $760.00
intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D
optic-haptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;
square edge design, precision power 0.25D steps: +18.0 to +28.0; Cylinder
calculation, aberration technology, toric powers from 1.0D to 6.0D
correction on anterior surface with cylinder
marks to indicate flat meridian plus the
cylinder axis to allow alignment for astigmatic
correction, and UV filter.
DV253 HOYA AF-1 351 Toric Preloaded injector system, correct corneal IOL Power: + 10.0 to 30.0 (0.5 steps), IOL $800.00
T3/T4/T5/T6/T7/T8/T9 astigmatism micro-incision, ashperic, blue- Cylinder power: 1.50D (351T3), 2.25D
blocker, single piece hydophobic. (351T4), 3.00D (351T5), 3.75D (351T6),
4.50D (351T7), 5.25D (351T8), 6.00D
(351T9)
AL024 AcrySert model SN60WS Foldable Acrylic Single-piece Lens with Blue +6 to +30 D $405.00
light protection and aspheric correction, in
cartridge.
AL031 AcrySert C Model SN6CWS Posterior chamber, UV absorbing, foldable, +6.0 to +30.0 D $405.00
acrylic, single piece lens with blue light
protection and aspheric correction, in cartridge
AL039 AcrySof IQ Aspheric IOL with Pre-loaded foladable Acrylic Single-piece +6.0D to +30.0D $405.00
UltraSert pre-loaded delivery Lens with Blue light protection and Aspheric
correction (SN60WF)
BL035 MICRO+ AY 123 Preloaded, posterior chamber, UV absorbing, An overall diameter of 10.75mm and optic $405.00
foldable, aspheric, acrylic, single piece lens diamter of 6.15mm. From 0 to +35 diopters
with blue light protection. with 0.5 diopter increments.
Prostheses List by Category, Groups and Sponsor Page 10 of 973
BL037 MicroPure 123 Preloaded, posterior chamber, UV absorbing, Overall diameter of 10D to 24.5D: 11.00mm $405.00
foldable, aspheric, acrylic, single piece
hydrophobic glistening-free Intra Ocular 25D to 30D: 10.75mm
Optic diameter of 10D to 24.5D: 6.00mm
25D to 30 D: 5.75mm
Power from 10D to 30D with 0.5 diopter
increments.
DV250 Hoya-PS AF-1 (UY) PY-60AD Preloaded in cartridge, Aspheric, Blue +6.0D to +30.0D (0.5D steps) $405.00
blocker, Foldable, Single-Piece, Hydrophobic
DV252 HOYA iSert® 251 Preloaded injector system, Micro-incision, +6.0D to 30.0D (5 steps) $405.00
Aspheric, Blue-Blocker, Single Piece,
Hydrophobic
DV262 Hoya 751 Intra Ocular Lens Intra Ocular Lens Power +10 dioptres - +26 dioptres $405.00
DV264 Hoya Vivinex iSert Preloaded IOL Intra Ocular Lens Power +6 dioptres - +30 dioptres $405.00
(Model XY1)
IS034 BiFlex Preloaded 877PAY Posterior Chamber IOL, special 360° sharp Optic diameter: 6.0 mm ±0.10 mm, Overall $405.00
Hydrophobic Acrylic Foldable edge, Aspheric - Aberration Balanced diameter: 13.0 mm ±0.20 mm Powers
Aspheric Monofocal Lens with Blue available: -0.0 - +9.0 D ±0.25 D increment:
light Filter 1.0 D
D ±0.25 D increment: 0.5 D
+25.5- +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +35.0 D ±0.5 D increment: 1
IQ016 PreciSAL P302A Preloaded Acrylic, single piece, foldable Available in dioptric powers from 0.0 to $405.00
intraocular lens with anterior and posterior +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:
optic-haptic square edge, 360 degree optic +10.5 to +17.5 and +28.5 to +30.0; 0.25D
square edge design, precision power steps: +18.0 to +28.0
calculation, aberration technology and blue
light filter.
VI001 Nidek SZ-1 Pre-Loaded IOL Pre-Loaded Intra Ocular Lens Implantation Power +11 dioptres to 30+ dioptres $405.00
Injector System system
SO067 HumanOptics Aspira Y Preloaded Preloaded posterior chamber IOL, foldable, +10.0 to +30.0 D $405.00
UV absorber, Aspheric, aberration
technology, 360° LEC barrier, HD optic, Blue
Prostheses List by Category, Groups and Sponsor Page 11 of 973
SO071 Mediphacos Easyflex Preloaded posterior chamber IOL, foldable, +5.0 to +30.0 D $405.00
UV absorber, Aspheric, aberration
technology, double square edge, Blue light
AO039 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber Intraocular +5.0 to +34.0 diopter powers in 0.5 diopter $740.00
lens, incorporates a proprietary wavefront increments. Cylinder power: 1.00 diopter,
designed toric aspheric optic with a squared 1.50 diopter, 2.25 diopter, 3.00 diopter, 3.75
posterior optic edge designed to provide a diopter, 4.00 diopter, 4.50 diopter, 5.25
360 degree barrier. The edge of the optic has a diopter and 6.00 diopter (as measured at the
frosted design to reduce potential edge glare IOL plane). Overall diameter 13mm, Optic
size 6mm.
DE390 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size 6.0mm, overall length 11.0mm. $740.00
monofocal toric acrylic IOL Sph +/-0.0D to +35.0D (in 0.01D
increments) Cyl +0.25 to +6.99D cyl (in
DE397 Oculentis LENTIS Tplus LS-313 Foldable one-piece monofocal toric acrylic Optic Size 6.0mm, Overall Length 11.00mm. $740.00
T1-T6 Available diopters: +10.0D to +30.0D
(0.5D). Cyl: (T1 +1.5D) (T2 +2.25D) (T3
+3.0D) (T4 +3.75D) (T5 +4.5D) (T6 +5.25D)
IS024 Medicontur BiFlex 677TA Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $740.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens without Blue light Filter Aspheric – Coma optimized – Toric Powers available:
- +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
SO060 HumanOptics Torica Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 1D to 6D $740.00
absorber, Aspheric, aberration technology,
360° LEC barrier, HD optic
Prostheses List by Category, Groups and Sponsor Page 12 of 973
IS028 Medicontur BiFlex 677PTY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $800.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:
- +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
IQ020 PreciSAL Toric PT302A Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $800.00
intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D
optic-haptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;
square edge design, precision power 0.25D steps: +18.0 to +28.0; Cylinder
calculation, aberration technology, toric powers from 1.0D to 6.0D
correction on anterior surface with cylinder
marks to indicate flat meridian plus the
cylinder axis to allow alignment for astigmatic
correction, and UV and blue light filters.
DE392 Oculentis LENTIS LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall length 11.00mm. $780.00
monofocal toric acrylic IOL. Violet Light Sph +/-0.0D to +35.0D (in 0.01D
increments) Cyl +0.25D to +6.99D cyl (in
0.01D increments)
IS022 Medicontur BiFlex 677TAY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $780.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:
- +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
Prostheses List by Category, Groups and Sponsor Page 13 of 973
IQ019 PreciSAL Toric T302A Acrylic single piece, foldable intraocular lens Available in spherical dioptric powers from $780.00
with anterior and posterior optic-haptic 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D
square edge, 360 degree optic square edge steps: +10.5 to +17.5 and +28.5 to +30.0;
design, precision power calculation, 0.25D steps: +18.0 to +28.0; Cylinder
aberration technology, toric correction on powers from 1.0D to 6.0D
anterior surface with cylinder marks to
indicate flat meridian plus the cylinder axis to
allow alignment for astigmatic correction, and
UV and blue light filters.
LN005 ALSAFIT TORIC VF Single piece toric aspheric foldable Diopter power range: Sphere: From 0.0 D to $780.00
intraocular lens for implantation into the +32.00 D (0.50 D increments). Cylinder:
capsular bag. Violet filter. From +0.50 D to +6.00 D (0.50 D
increments).
SO057 HumanOptics Torica Y Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 1D to 6D $780.00
absorber, Aspheric, aberration technology,
360° LEC barrier, HD optic, Blue light filter
SO072 Mediphacos Miniflex Toric Toric posterior chamber IOL, foldable, UV Sphere +5.0 to +30.0 D, Cylinder < 7D $780.00
absorber, Aspheric, aberration technology,
double square edge, Blue light filter
AO040 TECNIS® Toric 1-Piece IOL 1-piece IOL Posterior chamber Intraocular +5.0 to +34.0 diopter powers in 0.5 diopter $1,042.00
lens, incorporates a proprietary wavefront increments. Cylinder power: 7.00 diopter,
designed toric aspheric optic with a squared 8.00 diopter (as measured at the IOL plane).
posterior optic edge designed to provide a Overall diameter 13mm, Optic size 6mm.
360 degree barrier. The edge of the optic has a
frosted design to reduce potential edge glare
DE391 Oculentis LENTIS Tplus LU-313T Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall length 11.00mm. $1,042.00
monofocal toric acrylic IOL Sph +/-0.0D to +35.0D (in 0.01D
increments) Cyl +6.99D to +12.0D cyl (in
0.01D increments)
Prostheses List by Category, Groups and Sponsor Page 14 of 973
IS025 Medicontur BiFlex 677TA Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,042.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens without Blue light Filter Aspheric – Coma optimized – Toric Powers available:
- +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
1.0 D
SO059 HumanOptics Torica Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 7D to 12D $1,042.00
absorber, Aspheric, aberration technology,
360° LEC barrier, HD optic
IS027 Medicontur BiFlex 677PT Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,052.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens without Blue light Filter, Aspheric – Coma optimized – Toric Powers available:
Preloaded -10.0 - +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
1.0 D
DE393 Oculentis LENTIS T plus LU-313-TY Patient Specific: Foldable one-piece Optic Size: 6.0mm, overall length 11.00mm. $1,084.00
monofocal toric acrylic IOL. Violet Light Available diopters: Cyl +7.00D to +12.0D
inclusive in 0.01D increments.
IS023 Medicontur BiFlex 677TAY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,084.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:
- +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
1.0 D
Prostheses List by Category, Groups and Sponsor Page 15 of 973
IS030 Medicontur BiFlex 677TBY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, $1,084.00
Hydrophilic Acrylic Foldable Toric Edge, Overall diameter: 13.0 mm ±0.20 mm
Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:
- +9.0 D ±0.25 D increment: 1.0 D
- +25.0 D ±0.25 D increment: 0.5 D
- +30.0 D ±0.5 D increment: 0.5 D
1.0 D
SO058 HumanOptics Torica Y Toric posterior chamber IOL, foldable, UV Sphere +10D to +30D, Cylinder 7D to 12D $1,084.00
absorber, Aspheric, aberration technology,
360° LEC barrier, HD optic, Blue light filter
IS029 Medicontur BiFlex 677PTY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.05 mm, Overall $1,094.00
Hydrophilic Acrylic Foldable Toric Edge, diameter: 13.0 mm ±0.10 mm
Lens with Blue light Filter Aspheric – Coma optimized – Toric Powers available:
- +30.0 D ±0.25 D increment: 0.5 D
- +35.0 D ±0.5 D increment: 1.0 D
0.75 D
1.0 D
AL021 Alcon AcrySof SN60WF Foldable Acrylic Single-piece Lens with Blue + 6.0 D to +30.0 D $385.00
Light Protection and Aspheric Correction
BL025 SofPort Advanced Optic (AO) Posterior chamber, aphakic, foldable silicone, 6mm optic 13mm overall lengthModified C $385.00
Violet Shield anterior & posterior edge modification 5 degree angulation 0-30D, 0.5D steps
intraocular lens with aberration technology, a
violet light
DV247 HOYA AF-1 iMics1 NY-60 Mini Incision, Aspheric, Blue-blocker, +6.0D to 30.0D (0.5 steps) $385.00
Single-piece, Hydrophobic
DE402 Oculentis LENTIS LS-312Y Foldable one-piece monofocal C Loop Acrylic Optic Size 6.0mm, Overall Length 12.0mm. $385.00
IOL. Violet Light filter. Available Diopters: +-0.0D to 35.0D (1.0D
steps) +15.5D to 26.5D (0.5D steps).
Prostheses List by Category, Groups and Sponsor Page 16 of 973
DE403 Oculentis LENTIS LS-313Y Foldable one-piece monofocal acrylic plate Optic Size 6.0mm, Overall Length 11.00mm. $385.00
haptic IOL. Violet Light Filter Available Diopters: +-0.0D to 35.0D (1.0D
steps). +15.5D to 26.5D (0.5D steps).
IS016 BiFlex 677ABY Hydrophilic Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $385.00
Acrylic Foldable Aspheric Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
Monofocal Lens with Blue light Powers available:
-10.0 - +9.0 D ±0.25 D increment: 1.0 D
+10.0 - +25.0 D ±0.25 D increment: 0.5 D
+25.5 - +30.0 D ±0.5 D increment: 0.5 D
+31.0 - +45.0 D ±0. D increment: 1.0 D
IS033 BiFlex 877FABY Hydrophobic Posterior Chamber IOL, special 360° sharp Optic diameter: $385.00
Acrylic Foldable Aspheric edge, Aspheric - Aberration Balanced 6.0 mm ±0.10 mm, Overall diameter: 13.0 mm
Monofocal Lens with Blue light ±0.20 mm
Powers available: -0.0 - +9.0 D ±0.25 D
D ±0.25 D
increment: 0.5 D +25.5- +30.0 D ±0.5 D
increment: 0.5 D
+31.0 - +35.0 D ±0.5 D increment: 1
IQ009 Softec HDY Acrylic, single piece, foldable intraocular lens Available in dioptric powers from -5.0 to + $385.00
with anterior and posterior optic-haptic 36.0, 1D steps: -5.0 to +10.0 and +31.0 to
square edge, 360 degree optic square edge +36.0; 0.5D steps: +10.5 to +18.0 and +25.0
design, precision power calculation, to 29.5; 0.25D steps: + 18.0 to +25.0
aberration technology and blue light filter
IQ015 PreciSAL 302A Acrylic, single piece, foldable intraocular lens Available in dioptric powers from 0.0 to $385.00
with anterior and posterior optic-haptic +30.0. 1D steps: 0.0 to +10.0; 0.5D steps:
square edge, 360 degree optic square edge +10.5 to +17.5 and +28.5 to +30.0; 0.25D
design, precision power calculation, steps: +18.0 to +28.0
aberration technology and blue light filter.
SO055 HumanOptics Aspira Y Posterior chamber IOL, foldable, UV absorber, -6.0 to +40.0 D $385.00
Aspheric, aberration technology, 360° LEC
barrier, HD optic, Blue light filter
SO073 Mediphacos Miniflex/Mediflex Posterior chamber IOL, foldable, UV absorber, +5.0 to +30.0 D $385.00
Aspheric, aberration technology, double
square edge, Blue light filter
Prostheses List by Category, Groups and Sponsor Page 17 of 973
KG003 Rayner Standard Toric C-Flex Hydrophilic HEMA-MMA copolymer, 5.00mm dia optic, 12.00mm dia overall, cyls $698.00
foldable with injector 2.0D to 6.0D in 2D increments
AL032 AcrySof IQ Toric IOL Posterior chamber, UV absorbing, foldable, +6 to +30 D spherical; 1.00 to 6.00 D $780.00
acrylic, toric, single piece lens with blue light
protection and aspheric correction
DV251 HOYA AF - 1 311 Toric T3/T4/T5 Correct Corneal Astigmatism, Micro- lOL Power: 6.0D to 30.0D (0.5 steps)lOL $780.00
incision,Aspheric, Blue-Blocker, Single Cylinder Power: 1.50D (311T3), 2.25D
Piece, Hydrophobic (311T4), 3.00D (311T5)
AL023 Alcon AcrySof Toric PC IOL Models Posterior chamber, UV absorbing, foldable, +6 to +34 D spherical; 1.50 to 6.00 D $740.00
acrylic, toric, single piece lens with blue light
protection
KG004 Rayner Premium Toric C-Flex HEMA-MMA copolymer, foldable with 5.75mm dia optic, 12.00mm dia overall, cyls $1,000.00
1.5D to 11.0D in 0.5D increments
KG013 Rayner Super Premium Toric I.O.L. Acrylic foldable toric single piece I.O.L -10.0D to 0.00D Sphere: 1D to 11.00D $1,000.00
+31.00D to +35.00 Spit: 1D to
11.00D Cylinder in 0.25steps
AL016 Alcon Acrysof Natural Model Foldable Acrylic Single-piece Lens, +6 to +40D $364.00
SN60AT asymmetric optic/consistent edge, with blue
AL025 AcrySof Multipiece Models Foldable Acrylic multi-piece Lens with Blue - 5 D to + 30 D $364.00
MN60MA, MN60AC light Protection
Prostheses List by Category, Groups and Sponsor Page 18 of 973
FS001 IC-8, Hydrophobic Small Aperture A hydrophobic posterior chamber intraocular The overall diameter is 12.5 millimetres with $780.00
Intraocular Lens lens (IOL), embedded with a central circular a 6 millimetre diameter aspheric optic.
mask, which operates under the principle of
small aperture optics to reduce near vision
blur and provide seamless extended range
vision from distance to near.
AO026 TECNIS® Multifocal Intraocular Posterior chamber lens with UV light- +5 to +34 diopter powers in 0.5d increments. $822.00
Lens (ZMA00) absorbing, foldable acrylic, 3-piece with a Overall diameter 13mm, Optic size 6mm
diffractive posterior optic and a modified
anterior surface technology with edge
modification and 360 degree square edge.
AO027 TECNIS® Multifocal 1-Piece Lens, A multifocal posterior chamber lens with UV- 6.0mm Optic Diameter x 13.0mm in overall $822.00
Models ZMB00, ZKB00, ZLB00 blocking, foldable acrylic, 1-piece with a length. +5.0 Diopter to +34.0 Diopter in 0.5
diffractive posterior optic and a modified Diopter increments. ZMB00 +4.00 Diopter
anterior surface technology with edge add, ZKB00 +2.75 add,
modification and a 360 degree square edge.
AO037 TECNIS® Symfony Extended Range Extended Range of Vision Posterior Chamber +5.0 to 34.0 diopter powers in 0.5 diopter $822.00
of Vision (ZXR00) IOL increments Overall diamter 13mm, Optic size
6mm
CZ015 AT LISA 809M ZEISS micro incision, aspheric multifocal 6mm optic, 11mm diameter. Diopter range $822.00
Diffractive bifocal anterior surface with 0.0D to +32.0D (0.5D steps)
asymmetric light distribution (65% distance /
35% near), 3.75D addition for near focus.
DE396 Oculentis LENTIS Mplus LS-313 Foldable one-piece multifocal plate haptic Overall Length 11.0mm and Optic Size $822.00
acrylic IOL. 6.0mm Available diopters +-0.0D to +36.0D
(0.05D steps)
Prostheses List by Category, Groups and Sponsor Page 19 of 973
IQ023 PreciSAL Multifocal M302AC Acrylic single piece, foldable intraocular lens Available in spherical dioptric powers from $822.00
with anterior and posterior optic-haptic edge, 0.0D to +30.0D. 1D steps: 0.0D to+10.0D;
360 degree optic square edge design, 0.5D steps: +10.5 to +17.5 and +28.5 to
precision power calculation, abreration +30.0; 0.25D steps: +18.0 to +28.0; near
technology, pupil independent diffractive sight correction addition up to +3.5D on all
anterior surface with a near sigh correction spherical dioptric powers.
addition of up to +3.5D, and UV Filter.
KG009 Rayner "M-Flex" Mulitfocal Acrylic, Foldable, Single piece multi-zoned 6.5mm Optic-Overall diameter 12.5mm: +3D $822.00
Foldable IOL refractive aspheric multifocal with Amon- or + 4D Addition: +14D to +25D in 1.0D
Apple 360 Degree Square edge, Anti Vaulting increments: +8.5D to +23.5D in 0.5D
increments
SO063 HumanOptics Diffractiva Multifocal posterior chamber IOL, foldable, Sphere: +10D to +30D, Near addition +3.5D $822.00
UV absorber, Aspheric, aberration
technology, 360° LEC barrier, HD optic
AO036 TECNIS® Multifocal 1-Piece IOL Preloaded 1-Piece Multifocal posterior +5.0 to 34.0 diopter powers in 0.5 diopter $842.00
with iTec Preloaded delivery system chamger IOL increments Overall diamter 13mm, Optic size
6mm
CZ033 AT LISA 809MP Preloaded, micro incision, aspherical bifocal, Diopter range: 0.0 to 32.0 $842.00
square edged, single-piece IOL for capsular Optic size: 6.0mm. Overall length: 11.0mm
bag fixation. The anterior aspheric bifocal
surface has an asymmetric light distribution
65/35 for distance/near vision, and 3.75D add
for the near focus.
CZ034 AT LISA tri 839MP Trifocal (aspheric) micro incision, single- Diopter range: 0.0 to +32.0D (0.5D $842.00
piece IOL for capsular bag fixation, increments). Optic size: 6.0mm. Overall
Length: 11.0mm
The trifocal (anterior) optic provides two
diffractive focal points (+3.33D near focus and
+1.66D intermediate focus) with asymmetric
light distribution 50% distance / 20%
intermediate / 30% near vision.
Prostheses List by Category, Groups and Sponsor Page 20 of 973
IQ024 PreciSAL Mulitfocal PM302AC Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $842.00
intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D
optichaptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;
square edge design, precision power 0.25D steps: +18.0 to +28.0; near sight
calculation, aberration technology, pupil correction addition up to +3.5D on all
independent diffractive anterior surface with a spherical dioptric powers.
near sight correction addition of up to +3.5D,
and UV filter.
SO065 HumanOptics Diffractiva Preloaded Preloaded Multifocal posterior chamber IOL, Sphere: +10D to +30D, Near addition +3.5D $842.00
foldable, UV absorber, Aspheric, aberration
technology, 360° LEC barrier, HD optic
CZ035 AT LISA toric 909MP ZEISS pre-loaded, micro incision, multifocal 6mm optic, 11mm diameter. Diopter range: $1,218.00
toric IOL. Aspheric toric anterior surface, Sph +6.0D to 24.0D, Cyl +1.0 to 4.0D (all
diffractive bifocal posterior surface with 0.5D steps)
asymmetric light distribution (65% distance/
35% near), and 3.75D addition for near focus.
CZ036 AT LISA tri Toric 939MP Trifocal (aspheric), bitoric, micro incision, Diopter range -10.00 to +28.0 and +1 to +4.0 $1,218.00
single-piece IOL for capsular bag fixation, DC Optic size: 6..00mml; Overall length:
implantable with preloaded injector system. 11.mm
The trifocal (anterior) optic provides two
diffractive focal points (+3.33D near focus and
+ 1.66D intermediate focus) with asymmetric
light distribution 50% distance / 20%
intermediate / 30% near vision,
IS020 Medicontur BiFlex Preloaded Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $884.00
677PMY Hydrophilic Acrylic Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
Foldable Multifocal Lens with Blue Powers available:
light Filter -10.0 - +9.0 D ±0.25 D increment: 1.0 D
0.5 D
0.5 D
1.0 D
Prostheses List by Category, Groups and Sponsor Page 21 of 973
IS021 Medicontur QFlex 640PMY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $884.00
Hydrophilic Acrylic Foldable Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
Multifocal Lens with Blue light Powers available:
1.0 D
0.5 D
0.5 D
1.0 D
IQ025 PreciSAL Multifocal PM302A Pre-loaded acrylic single piece, foldable Available in spherical dioptric powers from $884.00
intraocular lens with anterior and posterior 0.0 to +30.0. 1D steps: 0.0 to +10.0; 0.5D
optichaptic square edge, 360 degree optic steps: +10.5 to +17.5 and +28.5 to +30.0;
square edge design, precision power 0.25D steps: +18.0 to +28.0; near sight
calculation, aberration technology, pupil correction addition up to +3.5D on all
independent diffractive anterior surface with a spherical dioptric powers.
near sight correction addition of up to +3.5D,
and UV and blue filter powers.
SO066 HumanOptics Diffractiva Y Preloaded Multifocal posterior chamber IOL, Sphere: +10D to +30D, Near addition +3.5D $884.00
foldable, UV absorber, Aspheric, aberration
technology, 360° LEC barrier, HD optic, Blue
light filter
AO033 TECNIS® Multifocal Toric Toric Multifocal Intraocular Lens Available +5.0 Diopters to +34.0 Diopters $1,198.00
Cylinder powers
1.50D, 2.25D, 3.00D and 4.00D (as
measured on the IOL plane).
AO038 TECNIS Symfony Toric Extended Extended Range of Vision Toric Multifocal +6 to +30 in 0.5d steps Available Cyl $1,198.00
Range of Vision (ZXT00) Posterior Chamber IOL powers +1.0d, 1.5d, 2.25d, 3.00d, 3.50d
CZ038 AT LISA tri toric 939M low cylinder Trifocal (aspheric), bitoric, micro incision, Diopter range: -10.00 to + 32.0 DS and +1 to $1,198.00
+6.5DC
The trifocal (anterior) optic provides two Optic Size: 6.0mm. Overall Length: 11.0mm
diffractive focal points (+3.33D near focus and
+1.66D intermediate focus) with asymmetric
light distribution 50% distance / 20%
intermediate / 30% near vision.
Prostheses List by Category, Groups and Sponsor Page 22 of 973
DE388 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal-toric Overall Length 11.0mm and Optic Size $1,198.00
313MFT plate haptic acrylic IOL 6.0mm + 0.0D to +36.0D inclusive in 0.01D
increments. Cyl +0.25 to +6.99D inclusive
in 0.01D increments
BL036 FineVision Toric POD FT Posterior chamber, toric, trifocal diffractive An overall diameter of 11.40mm and optic $1,240.00
(aspheric), UV and blue light blocker, single diameter of 6.00mm. From 0 to +35 Diopters
piece acrylic IOL. with 0.5 diopter increments.
DE394 Oculentis LENTIS Mplus Toric LU- Patient specific one-piece multifocal-toric Overall Length 11.0mm and Optic Size $1,240.00
313 MF30TY plate haptic acrylic IOL. 6.0mm, +-0.0D to +36.0D inclusive in 0.01D
increments. Cyl +0.25D to +6.99D inclusive
in 0.01D increments.
LN006 ALSAFIT TRIFOCAL TORIC VF Single piece trifocal toric aspheric foldable Diopter power range: Sphere: From 0.0 D to $1,240.00
introcular lens for implantation into the +32.00 D (0.50 D increments). Cylinder:
capsular bag. Violet filter. From +0.50 D to +6.00 D (0.50 D
increments).
CZ039 AT LISA tri toric 939M high Trifocal (aspheric), bitoric, micro incision, Diopter range: -10.00 to + 32.0 DS and +7 to $1,500.00
powered cylinder single-piece IOL for capsular bag fixation. The +12 DC
trifocal (anterior) optic provides two Optic Size: 6.0mm. Overall Length: 11.0mm
diffractive focal points (+3.33D near focus and
+1.66D intermediate focus) with asymmetric
light distribution 50% distance / 20%
intermediate / 30% near vision.
DE389 Oculentis LENTIS Mplus LU- Patient specific one-piece multifocal-toric Overall Length 11.0mm and Optic size $1,500.00
313MFT acrylic plate haptic IOL 6.0mm +-0.0D to +36.0D inclusive in 0.01D
increments. Cyl +6.99D to +12.0D inclusive
in 0.01D increments
Prostheses List by Category, Groups and Sponsor Page 23 of 973
DE395 Oculentis LENTIS Mplus LU-313 Patient specific one-piece multifocal toric Overall Length 11.00mm and Optic Size $1,542.00
MFTY plate haptic acrylic IOL. Violet Light Filter 6.0mm +-0.0D to +36.0D inclusive in 0.01D
Cyl +7.00D to +12.0D inclusive
in 0.01D increments.
AL028 AcrySof IQ ReSTOR SN6AD3 Posterior Chamber, UV absorbing, foldable, +6 D to + 34 D $864.00
acrylic, single piece lens with apodised
diffractive optic and blue light protection
AL030 AcrySof IQ ReSTOR SN6AD1, Posterior Chamber, UV absorbing, foldable, +6 D to + 34 D $864.00
SV25T0 and MN6AD1 acrylic, single piece lens with apodised
diffractive optic and blue light protection
AL040 AcrySof IQ PanOptix Presbyopia Trifocal posterior chamber, UV absorbing, +13.0 to +30.0D in 0.5 Diopter increments $864.00
Correcting IOL foldable, acrylic, aspheric, single piece lens and +31.0 to +34.0D in 1.0 Diopter
with apodised diffractive trifocal optic and
blue light protection.
The apodised diffractive trifocal optic
(anterior) provides two diffractive focal points
(+3.25D near focus and 2.17D intermediate
BL033 FineVision POD F Posterior chamber, UV absorbing, foldable, An overall diameter of 11.40mm and optic $864.00
aspheric, acrylic, single piece lens with diameter of 6.00mm. From 0 to +35 diopters
apodised diffractive, trifocal optic and blue with 0.5 diopters with 0.5 diopter
light protection
BL034 FineVision Micro F Posterior chamber, UV absorbing, foldable, An overall diameter of 10.75mm and optic $864.00
aspheric, acrylic, single piece lens with diameter of 6.15mm. From 0 to +35 dopters
apodised diffractive, trifocal optic and blue with 0.5 diopter increments.
light protection
DV248 HOYA PY-60MV Preloaded in cartridge, Multifocal, Aspheric, +14.0D to 27.0D (0.5 steps) $864.00
Blue-blocker, Single Piece, Hydrophobic
Prostheses List by Category, Groups and Sponsor Page 24 of 973
IS019 Medicontur BiFlex 677MY Posterior chamber IOL, 360° Special Square Optic diameter: 6.0 mm ±0.10 mm, Overall $864.00
Hydrophilic Acrylic Foldable Edge, Aspheric – Coma optimized diameter: 13.0 mm ±0.20 mm
Multifocal Lens with Blue light Powers available:
1.0 D
0.5 D
0.5 D
1.0 D
IQ022 PresiSAL Multifocal M302A Acrylic single piece, foldable intraocular lens Available in sperical dioptric powers from $864.00
with anterior and posterior optic-haptic 0.0D to +30.0D. 1D steps: 0.0D to +10.0D;
square edge, 360 degree optic square edge 0.5D steps: +10.5 to +17.5 and +28.5 to
design, precision power calculation. +30.0; 0.25D steps: +18.0.0 to +28.0; near
Aberration technology, pupil independent sight correction addition up to +3.5D on all
diffractive anterior surface with a near sight spherical dioptric powers.
correction addition of up to +3.5D, and UV
and blue light fliters.
LN004 ALSAFIT TRIFOCAL VF Single piece trifocal aspheric foldable Diopter power range: 0.0 D to +32.00 D $864.00
intraocular lens for implantation into the (0.50 D increments).
capsular bag. Violet filter. Optic size: 6mm. Overall length: 11.0mm.
SO064 HumanOptics Diffractiva Y Multifocal posterior chamber IOL, foldable, Sphere: +10D to +30D, Near addition +3.5D $864.00
UV absorber, Aspheric, aberration
technology, 360° LEC barrier, HD optic, Blue
CZ025 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL 6mm optic, 11mm diameter. Diopter range: $1,198.00
(standard cyl range). Aspheric toric anterior Sph -10.0D to +32.0D, Cyl +1.0 to 6.5D (all
surface, diffractive bifocal posterior surface 0.5D steps)
with asymmetric light distribution (65%
distance / 35% near), 3.75D addition for near
focus.
KG010 Rayner M-Flex Toric (Standard) Acrylic, Foldable, Single Piece, Multi-zoned 5.75mm / 12.0mm: 6.25mm / 12.5mm +3.00D $1,198.00
Refractive Aspheric Toric Mulitfocal with or +4.00D Addition FAR: +14.0D to
Amon-Apple enhanced 360 degree Square +32.00D in 0.5 STEPS: +2.00D +3.00D
edge, Anti Vaulting Haptics +4.00D Cylinder. NEAR: +14.0D to 27.0D
+4.00D
Prostheses List by Category, Groups and Sponsor Page 25 of 973
KG011 Rayner "M-Flex" Toric (Non Acrylic, Foldable, Single Piece, Muli-Zoned 5.75/12.0mm: 6.25/12.5mm +3.00D to $1,198.00
Standard) Refractive, Toric Multifocal with Amon-Apple +4.00D Addition FAR: +14.0D to +32.0D
enhanced 360 Degree square edge, Anti- in 0.5D Increments: NEAR: +14.0D to
vaulting Haptics, Patient Specific. +27.0D in 0.50D Increments Cylinder: 1.0D
to 1.5D and 2.5D to 6.00D in 0.5 increments
AL033 AcrySof IQ ReSTOR multifocal toric Posterior chamber UV absorbing foldable, +6 to +34 D spherical; 1.00 to 3.00 D $1,240.00
IOL (SND1T2-5; SV25T2-6) acrylic, aspheric, toric single piece lens with
apodised diffractive optic and blue light
protection.
CZ024 AT LISA toric 909M ZEISS micro incision, multifocal toric IOL 6mm optic, 11mm diameter. Diopter range: $1,500.00
(high cyl range). Aspheric toric anterior Sph -10.0D to +32.0D, Cyl +7.0 to 12.0D
surface, diffractive bifocal posterior surface (all 0.5D steps)
with asymmetric light distribution (65%
distance / 35% near), 3.75D addition for near
focus.
IL001 Crystalens HD Accommodating lens with > 3 Dioptres of 10.0 to 33.0 Dioptres in .05 Dioptre steps $780.00
accommodation with dual mechanism of
action: (1) forward axial movement of lens and
Posterior
chamber, polyspheric optics, 3-piece, plate
haptic, foldable UV light filtering, bic
IQ003 Tetraflex Acrylic single piece, foldable accommodating Available in dioptric powers from +5.0 to $780.00
intraocular lens with sqare edge design, +36.0, 1D steps: +31.0 to +36.0; 0.5D steps:
custom control precision and closed loop +5.0 to +18.0 and +25.0 to +30.0; 0.2D
steps; +18.0 to +25.0
Prostheses List by Category, Groups and Sponsor Page 26 of 973
IL002 Crystalens AO Accommodating lens designed to provide > 3 10.0 to 33.0 D in 0.50 Diopter steps. 10.0 - $822.00
Diopters of accommodation with dual 16.5 Diopters (12mm length) and 17.0 - 33.0
mechanism of action: (1) forward axial Diopters (11.5mm length).
movement of lens and (2) accommodative
Posterior chamber, aspheric,
aberration free optics, 3-piece, plate haptic, fol
DV246 Rayner Sulcoflex Ashperic Pseudophakic Supplementary I.O.L.O.L. -10.0D to -5.50D in 0.5D increments. $323.00
(Premium) I.O.L. +5.50D to 10.00D in 0.5D increments
KG008 Rayner "Sulcoflex" Pseudophakic Sulcoflex Aspheric Pseudophakic I.O.L -5D to +5D $365.00
I.O.L.
SO061 HumanOptics Torica Add-On IOL Toric Add-On IOL for sulcus fixation in Sphere: -4.0 to +1.5 in 0.5D steps, Cylinder $740.00
pseudophakic eyes, 3-piece, foldable, UV < 7D
absorber, blue light filter, Iris protection,
safety profile technology and undulated
SO062 HumanOptics Secura Add-On IOL Add-On IOL for sulcus fixation in -6.0 to +6.0 in 0.5D steps $385.00
pseudophakic eyes, 3-piece, foldable, UV
absorber, blue light filter, Iris protection and
safety profile technology
Prostheses List by Category, Groups and Sponsor Page 27 of 973
KG005 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric Pseudophakic SE -3 to +3 in 0.5 D stepsCyl +1 to +3 in $698.00
Pseudophakic Secondary I.O.L - Secondary IOL: Sulcus fixated with 1D steps
Standard undulating Haptics and Posterior Haptic
Angulation (Standard)
KG007 Rayner Sulcoflex Aspheric Toric Acrylic, Aspheric, Toric Pseudophakic SE -6.00 to +6.00 in 0.5 D steps Syl +1.00 to $698.00
Pseudophakic Secondary IOL Secondary IOL: Sulcus fixated with +6.00 in 0.5D steps
(Premium) undulating Haptics and Posterior Haptic
Angulation (Premium)
EG014 REVERSO Multifocal Intraocular lens -3 to +3 $780.00
KG006 Rayner "Sulcoflex" Aspheric Multi- Acrylic, Aspheric Multi-focal Pseudophakic 6.5mm / 13.5mm - 5.00D+5.00D sphere with $822.00
focal Pseudophakic Secondary IOL Secondary IOL: Sulcus-Fixated with + 3.00 Addition
Undulating Haptics and Posterior Haptic
Angulation
DV254 Rayner Premium Sulcoflex 653Z-Premium Multifocal Toric -7D to +7D (Spherical Equivalent) Cylinder $1,198.00
Multifocal Toric Supplementary IOL Supplementary IOL 1D, 4D, 5D, 6D Addition 3.5D
DV255 Rayner Standard Sulcoflex 653Z-Standard Multifocal Toric -3D to +3D (Spherical Equivalent) $1,198.00
Multifocal Toric Supplementary IOL Supplementary IOL Cylinders 2D and 3D Addition 3.5D
SO056 HumanOptics ToricaDiffractiva Toric Multifocal Add-On IOL for sulcus -2.0 to +0.5 in 0.5D steps, Cylinder < 7D, $1,240.00
Add-On IOL fixation in pseudophakic eyes, 3-piece, Near addition 3.5D
foldable, UV absorber, blue light filter, Iris
protection, safety profile technology and
undulated haptics.
Prostheses List by Category, Groups and Sponsor Page 28 of 973
SO068 HumanOptics Diffractiva Add-On Multifocal Add-On IOL for sulcus fixation in -6.0 to +6.0 in 0.5D steps, Near addition $864.00
IOL pseudophakic eyes, 3-piece, foldable, UV
absorber, blue light filter, Iris protection and
safety profile technology.
AL006 PROVISC VISCOELASTIC PROVISC contains sodium hyaluronate 0.85mL pack $80.00
SOLUTION
AL007 VISCOAT Viscoelastic Fluid Chondroitin sulfate and sodium hyaluronate 0.75mL $80.00
AL015 Cellugel viscoelastic fluid Hypromellose 2%. $80.00
AL029 DisCoVisc Ophthalmic Sodium hyaluronate 17 mg/mL and 0.5 mL and 1.0 mL $80.00
Viscosurgical Device chondroitin sulfate 40mg/mL
AO032 Healon Endocoat Viscoelastic 0.85ml $80.00
BL008 Ocucoat Intraocular Fluid 20mg/mL hydroxypropylmethyl cellulose for 1ml and 2ml Sterile $80.00
intraocular use
BL015 Amvisc Plus injection 15mg/mL Sodium Hyaluronate for intraocular 0.5mL and 0.8mL $80.00
use
CZ012 Z-HYALIN Viscoelastic Cohesive Viscoelastic Solution - sodium Volume 1.0ml $80.00
(previously called
Ophthalin)
CZ013 Z-HYALIN Plus Viscoelastic Cohesive Viscoelastic Solution - sodium Volume 1.0ml $80.00
(previously called
Opthalin Plus)
CZ022 VISTHESIA 1.5% VISCOANAESTHETIC syringe contains 0.8ml syringe & 2x0.3ml ampoules $80.00
sodium hyaluronate (NaHA, 1.5%) and
lidocaine hydrochloride (1%). Also contains
two topical ampoules with NaHA (0.3%) and
lidocaine (2%)
Prostheses List by Category, Groups and Sponsor Page 29 of 973
IQ002 Ocuvis and Ocumax 2% 20mg/mL hydroxypropylmethyl cellulose for 2mL sterile $80.00
Hydroxypropylmethylcellulose intraocular use. Pre-loaded in a sterile syringe
with one cannula for injection, in a sterile
Tyvek pouch
AO009 Healon 5, Intraocular Viscoelastic HEALON5- Sodium hyaluronate 23mg/ml. 0.6ml $85.00
Fluid
AO008 Healon, Intraocular Viscoelastic Sodium Hyaluronate 10mg/ml Healon 0.55ml & 0.85ml $80.00
AO010 Healon GV Intraocular Viscoelastic Sodium Hyaluronate 14mg/mL 0.55ml and 0.85ml $85.00
Fluid
AL005 DUOVISC VISCOELASTIC SYSTEM PROVISC contains sodium hyaluronate, Small & large packs $110.00
VISCOAT contains chondroitin sulfate and
sodium hyaluronate
CZ019 TWINVISC Viscoelastic TWINVISC includes a cohesive and a Total volume 1.4 ml $110.00
dispersive viscoelastic in one syringe,
Dispersive: sodium
Cohesive: sodium
DV231 Vision Blue Trypan blue dye for ophthalmic applications 0.5ml syringe $48.00
Prostheses List by Category, Groups and Sponsor Page 30 of 973
EG013 Retidyne Tissue staining in Ophthalmic Surgery 0.5ml Syringe Vial $48.00
AL001 Capsular Tension Rings - 10.0 - 12.0 compressed, 12.3 - 14.5 $159.00
uncompressed
AO021 Stabileyes Capsular Tension Ring Polymethylmethacrylate (PMMA) Implant 12mm ring, and 13mm ring $159.00
DV009 Morcher Capsular Tension Ring PMMA Implant 14, 14A, 14C $159.00
EG001 Capsular Tension Rings Clear PMMA Implant 10/08, 12/10, 13/11mm $159.00
DV029 Eyejet CRT Capsular tension ring made of PMMA per- 14 (10mm), 14C (11mm), 14A (12mm) $243.00
load on disposable injector
EG018 RINGJECT Preloaded Capsular tension ring 12/10, 13/11 $243.00
IL003 Preloaded Capsular Tension Ring Capsular tension ring preloaded (acrylic) 13/11mm $243.00
IS001 Preloaded Capsular Tension Ring Capsular tension ring preloaded (acrylic) 13/11mm $243.00
Prostheses List by Category, Groups and Sponsor Page 31 of 973
IS018 Jetring Preloaded PMMA (polymethyl methacrylate) JETRING 11ACB Right $243.00
capsular tension ring. Overall diameter: 13.0 mm ±0.20 mm
11,0 mm ±0.20 mm
ø0.17 mm ±0.02 mm
Haptic design: straight, open modified
C-loop
JETRING 12ACB Right
14.5 mm ±0.20 mm
12,0 mm ±0.20 mm
ø0,20 mm ±0.02 mm
straight, open modified
LN001 Inside CTR Preloaded PMMA capsular tension ring Type 14 (12.3mm open, 10.0mm compressed), $243.00
Type 14C (13.0mm open, 11.0mm
compressed), Type 14A ( 14.5mm open,
12.0mm compressed), Type 13 ( 12.3mm
open, 10.0mm compressed), Type 13A (
13.0mm open, 11.0mm compressed), Type
13B ( 14.5mm open, 12.0mm compressed),
Type 19D (11.6 mm open,
10.0/9.5/9.0/8.5mm compressed), Type 10C (
12.1mm open, 11.0mm compressed)
DV010 Morcher Coloboma Diaphram PMMA Implant 96G, 96L $334.00
AO012 Baerveldt Glaucoma Implant BG Non-valved artificial drainage device, Surface area 250, 350, 425mm2 $425.00
101-350, Baerveldt Glaucoma composition silicone - smooth, tumble-
Implant BG 103-425, Baerveldt polished finish
Glaucoma Implant BG 103-250
DV020 Molteno Implant Double plate - dual chamber One size only $425.00
Prostheses List by Category, Groups and Sponsor Page 32 of 973
DV242 Molteno Implant Glaucoma Drainage Device - Single N/A $425.00
Plate/Single Plate-Dual Chamber/Double
DV230 Molteno 3 Drainage implant for glaucoma, made of 2 Sizes: *230 mm square *175mm square $625.00
LN002 Ahmed Glaucoma Valve Model FP7 A sterile device designed to regulate the flow one size $625.00
of Fluid between the anterior chamber and the
space around the conjunctiva of the eye be
allowing flow when the pressure in the
SY328 Spine Solutions Prodisc Artificial mechanical disc, polyethylene inlay 10,12,14mm, Medium, Large $1,150.00
OH052 Interpore Bone Plate System TPS Bone Plate 20 - 56cm $2,300.00
OH303 ADD / ADDplus Addplus is a winged anterior distraction ADDplus, diameter 12mm, height 13-18mm. $2,300.00
device and is also used for vertebral column 6°ADDplus, diameter 12mm, height 17-
replacement which can be used for the anterior 26mm. 6°ADDplus, diameter 12mm, height
cervical column and for the cervico-thoracic 25-41mm. 6°ADDplus, diameter 12mm,
transition. The Adplus effects the height 40-65mm. 6°
reconstruction, support and stabilization
LB066 XP and R Corpectomy Spacer Expandable Corpectomy spacer Small, Medium,15-88mm in varying $3,100.00
lordotic/kyphotic angles
Prostheses List by Category, Groups and Sponsor Page 965 of 973
SY356 ECD - Expandable Corpectomy Vertebral body replacement system, Angle 4.5Deg/7Deg, Height 17mm - 70mm $3,100.00
Device PEEK/Titanium
NV102 X-Core Mini the NuVasive X-CORE Mini expandable VBR 15-80mm $3,100.00
System is a vertebral body repalcement device
for use in the spine (C3 to L5) to replace a
diseased or damaged vertebral body caused by
tumor or fracure, to restore height of a
collapsed vertebral body, and to achieve
decompression of the spinal cord and neural
tissues,
SX035 TeCorp Vertebral Body Replacement TeCorp Cervical All sizes $3,100.00
System
LB055 Xpand Corpectomy Spacer System Expandable corpectomy spacer small, Medium, Large. 15-120mm in varying $4,300.00
lordotic/kyphotic angles
BB288 Aesculap Vertebral Body System Vertebral Body System, Titanium Alloy All sizes $4,300.00
ER184 Signus Poseidon Vertebral Body SIGNUS Poseidon Vertebral Body Dia 20mm x (Height 35-88mm); $4,300.00
Replacement System-Vertebral Body
ER210 Capri Vertebral Body Replacement Cage, Internal or External Component 23 - 122mm height, multiple footprints $4,300.00
System-Cage
LB097 FORTIFY R Corpectomy Spacer Expandable corpectomy spacer 14mm $4,300.00
15mm-88mm
JJ782 X-MESH - Expandable Cage System Telescoping, vertebral body replacement Footprint/diameter 10-40mm, variable height $4,300.00
range
SY341 Expandable Cage Titanium Synex II, Titanium Height 14mm-123mm $4,300.00
SY343 Expandable Cage Titanium Synex, Titanium, with endplates Height 14mm - 93mm, Angle 0 - 40 degree $4,300.00
Prostheses List by Category, Groups and Sponsor Page 966 of 973
SY794 XRL Expandable Vertebral Body 22 - 121mm Height $4,300.00
MC507 LIFT/VERTE-SPAN Vertebral Body Cages Short - Extra Long $4,300.00
MC820 T2 Expandable vertebral body replacement cage Diameters: 13 - 31mm $4,300.00
NV078 X-CORE (Expandable cage) Expandable VBR Cage Diameter: 12-22mm $4,300.00
Height: 15-121mm
OH301 Obelisc vertebral body replacement Centre PieceMade from titanium. diameter - 20mm, height 20-28mmdiameter - $4,300.00
20mm, height 25-37mmdiameter - 20mm,
height 32-47mmdiameter - 20mm, height
40-62mmdiameter - 20mm, height 53-87mm
diameter - 20mm, height 76-132mm
PZ042 VerteLoc Expandable System Expandable Cage 20-100mm $4,300.00
SX036 TeCorp Vertebral Body Replacement TeCorp Thoracic All sizes $4,300.00
System
SX037 TeCorp Vertebral Body Replacement TeCorp Lumbar All sizes $4,300.00
System
HW515 GIZA vertebral Body Replacement A Titanium expandable Vertebral Body 14mm diameter, 18mm -54mm length, 2 deg to $4,300.00
System Replacement System with integral variable 10deg angulation.
angled endplates
SK448 VLIFT Vertebral Body Replacement System, DIS Diameters 12 to 22mm $4,300.00
Implant
ER185 Signus Poseidon Vertebral Body Signus Poseidon End Plate (23-26mm)x(25-43mm); 0-15 degrees $1,200.00
Replacement System-End Plate
LB096 FORTIFY Ti Corpectomy Spacer Expandable corpectomy spacer endplate 12 and 20mm x 12-50mm 0-12deg $1,200.00
Endplate
Prostheses List by Category, Groups and Sponsor Page 967 of 973
LB098 FORTIFY R Corpectomy Spacer Expandable corpectomy spacer endplate 14mm 14-18mm 0-7deg $1,200.00
Endplate
SY342 Expandable Cage Titanium Synex II, Titanium endplate Angle 0 - 40 degree. Endplate Size 19x20, $1,200.00
22x25, 26x30
SY795 XRL Endplate -10˚/+15˚ Degrees $1,200.00
NV079 X-CORE (End Cap) End plate Round 12-30mm x -8° to 16°; Rectangular $1,200.00
12-22mm x 15-60mm x -8° to 16°
OH302 Obelisc vertebral body replacement End PieceMade from titanium. diameter - 20mm, angle 0°diameter - 20mm, $1,200.00
angle 5°diameter - 20mm, angle 10°diameter -
24mm, angle 0°diameter - 24mm, angle 5°
diameter - 24mm, angle 10°diameter - 26mm,
angle 0°diameter - 26mm, angle 5°diameter -
26mm, angle 10°
SK339 VLIFT End cap Diameters 12 to 22mm $1,200.00
ZI678 InFix Interbody Fusion System Endplate Small - Large $1,200.00
ZI680 InFix Interbody Fusion System Endcap 8-10mm $1,200.00
ER164 Signus Athlet VBR System - Main Peek Vertebral Body Replacement System 12, 18, 24, 30, 36 and 42mm lengths $4,400.00
Body (Main body)
ER165 Signus Athlet VBR System - End Peek Vertebral Body Replacement System 4, 6, 8mm heights $4,400.00
Body (End body)
DP513 Stackable Corpectomy CFRP Cage Stackable Cage Xsmall-Xlarge $4,400.00
System
DY322 Carbon Fibre Interbody Fusion Stackable C/F Cage System Wedges 11 Degree Small-Large $4,400.00
MC603 Union Verte-Stack 8 - 20mm $4,400.00
Prostheses List by Category, Groups and Sponsor Page 968 of 973
MC606 Union Verte-Stack Centre Piece 5-40mm $4,400.00
MC632 Verte-Stack XS Centre Piece. Stackable Corpectomy Height 5-50mm $4,400.00
PZ021 VerteLoc Spine System Locking Screw 20mm - 150mm $4,400.00
PZ022 VerteLoc Spine System Stackable Cage Extra Small- Extra large $4,400.00
PZ023 VerteLoc Spine System Locking Nut one size only $4,400.00
ER175 Santorini Stackable Corpectomy Corpectomy Cage, Peek (12x17)mm footprint x (2-62)mm height $4,400.00
Cage-Small
ER176 Santorini Stackable Corpectomy Corpectomy Cage, Peek (16x20) or (21x25)mm footprint x (2-98)mm $4,400.00
Cage-Medium/Large height
DP427 Surgical Titanium Mesh System Various shapes 10- 26 x 15 -150mm $3,605.00
DP438 Surgical Titanium Mesh System Mesh - Oblong 12 - 13 x 15 -17mm x 10 - 20mm $3,605.00
SY293 Synmesh Mesh, Oblong 6mm - 88mm $3,605.00
SY294 Synmesh Mesh, Round 6mm - 88mm $3,605.00
MC378 Pyramesh Titanium Surgical Mesh 51 - 500mm $3,605.00
MC379 Pyramesh Titanium Surgical Mesh 5 - 50mm $3,605.00
MC449 Pyramesh Angled 25 - 150mm $3,605.00
MC450 Pyramesh Curved / Round 20 - 150mm $3,605.00
MC451 Pyramesh Ovoid 8 - 130mm $3,605.00
NV015 Titanium Mesh Oval/Flat/Long/Round 10mm - 16mm Diameter, 6mm - 14mm Length $3,605.00
NV016 Titanium Mesh Oval/Flat/Long/Round 10mm - 16mm Diameter, 15mm - 90mm $3,605.00
Length
Prostheses List by Category, Groups and Sponsor Page 969 of 973
NV017 Titanium Mesh Oval/Flat/Long/Round 20mm + Diameter, 30mm - 90mm Length $3,605.00
OF051 Blackstone - Surgical Mesh 4 lobe, 6 lobe 4 lobe: 12 x 15mm, 8mm - 17 x 22, 15mm, 6 $3,605.00
lobe: (diameter x height) 10 - 16 x 10 - 16mm
(2mm increments), 7 - 70mm
SX057 Novel CP Corpectomy Spinal PEEK vertebral body replacement, Small: 14mm width x 12mm depth; height: $3,605.00
Spacer System thoracolumbar 10mm - 50mm (2mm increments)Medium:
17mm width x 15mm depth; height: 10mm -
50mm (2mm increments)
SK338 VBOSS/VLIFT Titanium Available from 10 to 25mm in Diameter and $3,605.00
from 8 to 120mm in Length
BF002 A-Mesh Spinal Titanium Mesh A-Mesh® Spinal Titanium Mesh is designed Diameter: 10mm, Length: 20mm, 50mm 70mm $3,605.00
to restore biomechanical integrity throughout
the thoracic and lumbar spine following Diameter: 12mm, Length: 20mm, 50mm,
vertebrectomy or corpectomy for patients with 70mm
spine tumors or fractures. Diameter: 14mm, Length: 20mm, 50mm,
70mm
Diameter: 16mm, Length: 20mm, 50mm,
70mm, 90mm
Diameter: 20mm, Length: 20mm, 50mm,
70mm, 90mm
Diameter: 25mm, Length: 20mm, 50mm,
70mm, 90mm
Diameter: 30mm, Length: 20mm, 50mm,
70mm, 90mm
Diameter: 35mm, Length: 20mm, 50mm,
70mm, 90mm
DY087 Surgical Titanium Mesh System End Plate or Screws or End Cap (Round / 10-33mm $1,325.00
Oblong / Trapezoidal)
DY088 Surgical Titanium Mesh System Rings (Standard and Angled) 17-26mm x 22-33mm $1,325.00
Prostheses List by Category, Groups and Sponsor Page 970 of 973
SY295 Synmesh End rings round/oblong $1,325.00
MC539 Pyramesh End ring/cap 10 - 25mm $1,325.00
MC821 T2 End Cap 13-31 mm, 0, 4, 8, 15 degree lordosis $1,325.00
OF052 Blackstone - End Ring Surgical Mesh [Surgical mesh X Angle] 10-16mm (2mm $1,325.00
increments) X 0-2.5 degrees
SK424 VBOSS End cap Sizes 10 to 25mm $1,325.00
BF020 A-Mesh Spinal Titanium Mesh Plate A-Mesh Spinal Titanium Mesh is designed to Diameter 10m 12, 14, 16, 20, 15, 30 or 35mm $1,325.00
and Set Screw restore biomechanical integrity throughout
the thoracic and lumbar spine following
vertebrectomy or corpectomy for patients with
spine tumors or fractures
ER138 Santorini Solid Corpectomy Cage Cage, fixed height, Peek (12x14) or (16x20) mm footprint x (18-62) $3,605.00
System mm height
ER262 Amendia Samson Corpectomy Amendia Samson Corpectomy Vertebral Body dia 13.5x height (14-48 mm) $3,605.00
Vertebral Body Replacement System Replacement System
LB131 Niko Corpectomy Spacer PEEK Thoracolumbar pre-assembled Width 12 and 14mm, Length 14mm and $3,605.00
corpectomy cage 16mm, Height 15-33mm in 2mm increments
LH483 Coflex-F Interspinous fusion device 8, 10, 12, 14, 16mm $1,425.00
Prostheses List by Category, Groups and Sponsor Page 971 of 973
MC637 CD Horizon Spire Plate 35-41mm $1,425.00
NV064 Affix Plate Spinous process plate with an integrated 25mm - 55mm $1,425.00
canted-coil locking mechanism.
LB113 SP-Fix™ Spinous Process Fixation Posterior non-pedicle supplemental fixation 35-55mm $1,425.00
device
NK027 Axle Interspinous fusion System Interspinous fusion plate system Plates: 28mm to 55mm $1,425.00
Inserts: 8-18mm
SX091 Bridgepoint Spinous Process Spinous process fixation system with Small 35-40mm, Medium 40-45mm, Large 45- $1,425.00
Fixation System intergrated set screws 50mm
SV044 Romeo 2 PAD System Interspinous fusion device 8mm to 18mm $1,425.00
ER272 iFuse Implant System-Implant iFuse Implant System-Implant 4 & 7mm; length 30-70 mm $2,000.00
LB062 SI-LOK Stabilization System Fusion Screw 8.0-12.0mm diameter x 25-60mm length $2,000.00
NK045 Silex Joint Fixation Device Single-Thread Sacroiliac Anchor Implant or 12.5mm x 30-70mm $2,000.00
Dual-Thread Sacroiliac Anchor Implant
ZI918 TriCor Sacroiliac Joint Fusion Anchor Implant 12.5mm diameter, 30-70mm $2,000.00
System, Anchor Implant
Prostheses List by Category, Groups and Sponsor Page 972 of 973
GO274 Barricaid Annular replacement prosthesis Height: 14mm; Width 8mm, 10mm, 12mm $5,900.00
Prostheses List by Category, Groups and Sponsor Page 973 of 973
PART B - Human Tissue List
TBV56 Donor Tissue Bank of Victoria $1,749.00
QHV09 The Prince Charles Hospital - Queensland Heart Valve Bank $6,962.00
SHV03 Sydney Heart Valve Bank, St. Vincent's Hospital $2,581.00
TBV03 Donor Tissue Bank of Victoria $1,749.00
QHV08 The Prince Charles Hospital - Queensland Heart Valve Bank $7,294.00
QHV07 The Prince Charles Hospital - Queensland Heart Valve Bank $2,116.00
QHV03 The Prince Charles Hospital - Queensland Heart Valve Bank $1,926.00
QHV05 The Prince Charles Hospital - Queensland Heart Valve Bank $2,116.00
QHV04 The Prince Charles Hospital - Queensland Heart Valve Bank $1,926.00
TBV50 Donor Tissue Bank of Victoria $2,139.00
QHV11 The Prince Charles Hospital - Queensland Heart Valve Bank $2,116.00
QHV01 The Prince Charles Hospital - Queensland Heart Valve Bank $7,294.00
RPH01 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV01 Sydney Heart Valve Bank, St. Vincent's Hospital $7,752.00
TBV01 Donor Tissue Bank of Victoria $8,266.00
Page 1 of 16
QHV10 The Prince Charles Hospital - Queensland Heart Valve Bank $6,962.00
QHV02 The Prince Charles Hospital - Queensland Heart Valve Bank $7,294.00
RPH02 Royal Perth Hospital T/A Heart Valve Bank $6,406.00
SHV02 Sydney Heart Valve Bank, St. Vincent's Hospital $7,752.00
TBV02 Donor Tissue Bank of Victoria $8,266.00
SYN03 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $2,200.00
SYN07 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $27,000.00
QBB72 The Queensland Bone Bank $527.00
SYN06 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $14,000.00
QBB73 The Queensland Bone Bank $779.00
SYN04 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $3,500.00
QBB71 The Queensland Bone Bank $274.00
SYN05 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $5,700.00
LEM03 Lions Eye Donation Service $770.00
LEM01 Lions Eye Donation Service $2,000.00
LEN01 Lions NSW Eye Bank $2,287.00
LEW01 Lions Eye Bank of Western Australia $2,500.00
QEB01 Queensland Eye Bank $2,321.00
SAE01 The Eye Bank of South Australia $1,890.00
Page 2 of 16
LEN04 Lions NSW Eye Bank $2,695.00
LEW03 Lions Eye Bank of Western Australia $3,000.00
SAE03 The Eye Bank of South Australia $2,849.00
LEM04 Lions Eye Donation Service $2,660.00
LEN03 Lions NSW Eye Bank $1,372.00
LEM02 Lions Eye Donation Service $150.00
LEN02 Lions NSW Eye Bank $343.00
LEW02 Lions Eye Bank of Western Australia $250.00
QEB02 Queensland Eye Bank $329.00
SAE02 The Eye Bank of South Australia $230.00
MVS23 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $1,396.00
QBB60 The Queensland Bone Bank $1,733.00
RNB02 Hunter New England Bone Bank $1,470.00
QBB56 The Queensland Bone Bank $2,195.00
TBV52 Donor Tissue Bank of Victoria $683.00
TBV53 Donor Tissue Bank of Victoria $1,364.00
NBB62 New South Wales Bone Bank $1,169.00
NBB61 New South Wales Bone Bank $2,131.00
NBB60 New South Wales Bone Bank $3,232.00
Page 3 of 16
QBB09 The Queensland Bone Bank $1,778.00
QBB10 The Queensland Bone Bank $751.00
TBV09 Donor Tissue Bank of Victoria $1,394.00
TBV10 Donor Tissue Bank of Victoria $2,420.00
NBB65 New South Wales Bone Bank $1,169.00
NBB64 New South Wales Bone Bank $2,131.00
NBB63 New South Wales Bone Bank $3,232.00
SYN02 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $3,400.00
SYN01 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $2,650.00
TBV55 Donor Tissue Bank of Victoria $1,157.00
TBV54 Donor Tissue Bank of Victoria $578.00
PBT37 Perth Bone and Tissue Bank $750.00
PBT62 Perth Bone and Tissue Bank $550.00
PBT10 Perth Bone and Tissue Bank $4,050.00
PBT64 Perth Bone and Tissue Bank $2,050.00
PBT08 Perth Bone and Tissue Bank $2,950.00
Page 4 of 16
QBB45 The Queensland Bone Bank $2,202.00
QBB03 The Queensland Bone Bank $2,789.00
PBT09 Perth Bone and Tissue Bank $3,550.00
PBT38 Perth Bone and Tissue Bank $900.00
TBV11 Donor Tissue Bank of Victoria $1,618.00
PBT63 Perth Bone and Tissue Bank $1,150.00
TBV12 Donor Tissue Bank of Victoria $2,690.00
AUB02 Australian Biotechnologies $2,457.00
QBB68 The Queensland Bone Bank $2,235.00
QBB67 The Queensland Bone Bank $2,789.00
AUB08 Australian Biotechnologies $2,215.00
AUB04 Australian Biotechnologies $2,070.00
NBB05 New South Wales Bone Bank $1,584.00
PBT03 Perth Bone and Tissue Bank $1,200.00
TBV07 Donor Tissue Bank of Victoria $1,064.00
TBV08 Donor Tissue Bank of Victoria $1,133.00
SYN10 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,250.00
Page 5 of 16
SYN12 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,700.00
SYN11 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,250.00
SYN13 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,700.00
PBT11 Perth Bone and Tissue Bank $300.00
QBB12 The Queensland Bone Bank $232.00
TBV17 Donor Tissue Bank of Victoria $713.00
AUB05 Australian Biotechnologies $2,451.00
QBB52 The Queensland Bone Bank $487.00
TBV14 Donor Tissue Bank of Victoria $1,149.00
PBT07 Perth Bone and Tissue Bank $2,664.00
PBT48 Perth Bone and Tissue Bank $3,032.00
PBT06 Perth Bone and Tissue Bank $1,981.00
SYN08 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,450.00
SYN09 Johnson & Johnson Medical Pty Ltd t/a DePuy Synthes $1,800.00
QBB04 The Queensland Bone Bank $788.00
QBB14 The Queensland Bone Bank $2,437.00
TBV18 Donor Tissue Bank of Victoria $6,380.00
NBB09 New South Wales Bone Bank $1,193.00
TBV21 Donor Tissue Bank of Victoria $1,198.00
Page 6 of 16
PBT15 Perth Bone and Tissue Bank $1,590.00
QBB11 The Queensland Bone Bank $6.00
PBT16 Perth Bone and Tissue Bank $854.00
ACT01 ACT Bone Bank $2,432.00
AUB03 Australian Biotechnologies $2,354.00
CSA01 Rachel Forster Bone Bank $802.00
DHR01 Barwon Health Bone Bank $4,616.00
MVS05 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,370.00
NBB16 New South Wales Bone Bank $2,354.00
PBT22 Perth Bone and Tissue Bank $2,932.00
QBB27 The Queensland Bone Bank $2,390.00
RNB01 Hunter New England Bone Bank $2,500.00
TBV26 Donor Tissue Bank of Victoria $3,063.00
QBB61 The Queensland Bone Bank $2,390.00
QBB28 The Queensland Bone Bank $2,390.00
NBB59 New South Wales Bone Bank $2,939.00
PBT21 Perth Bone and Tissue Bank $2,900.00
TBV46 Donor Tissue Bank of Victoria $1,666.00
NBB17 New South Wales Bone Bank $2,078.00
PBT24 Perth Bone and Tissue Bank $1,800.00
QBB30 The Queensland Bone Bank $1,758.00
QBB31 The Queensland Bone Bank $740.00
QBB23 The Queensland Bone Bank $2,483.00
Page 7 of 16
QBB66 The Queensland Bone Bank $3,106.00
NBB57 New South Wales Bone Bank $3,595.00
NBB13 New South Wales Bone Bank $3,244.00
TBV24 Donor Tissue Bank of Victoria $2,751.00
NBB56 New South Wales Bone Bank $2,183.00
NBB55 New South Wales Bone Bank $2,183.00
PBT19 Perth Bone and Tissue Bank $3,200.00
MVS02 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT17 Perth Bone and Tissue Bank $4,220.00
TBV22 Donor Tissue Bank of Victoria $4,755.00
NBB10 New South Wales Bone Bank $3,595.00
QBB20 The Queensland Bone Bank $3,094.00
NBB11 New South Wales Bone Bank $3,372.00
MVS03 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB12 New South Wales Bone Bank $8,023.00
QBB22 The Queensland Bone Bank $4,717.00
TBV23 Donor Tissue Bank of Victoria $7,790.00
PBT18 Perth Bone and Tissue Bank $8,000.00
MVS04 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT20 Perth Bone and Tissue Bank $4,220.00
TBV25 Donor Tissue Bank of Victoria $4,722.00
Page 8 of 16
NBB15 New South Wales Bone Bank $3,780.00
QBB25 The Queensland Bone Bank $3,337.00
NBB14 New South Wales Bone Bank $1,690.00
TBV51 Donor Tissue Bank of Victoria $4,590.00
MVS07 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB18 New South Wales Bone Bank $7,817.00
PBT25 Perth Bone and Tissue Bank $3,500.00
QBB32 The Queensland Bone Bank $2,930.00
TBV27 Donor Tissue Bank of Victoria $7,518.00
NBB54 New South Wales Bone Bank $3,053.00
PBT28 Perth Bone and Tissue Bank $2,000.00
MVS14 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
TBV29 Donor Tissue Bank of Victoria $1,490.00
MVS13 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
TBV28 Donor Tissue Bank of Victoria $1,064.00
TBV30 Donor Tissue Bank of Victoria $2,818.00
MAA01 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00
MAA03 MEDTRONIC AUSTRALASIA PTY LTD $1,800.00
MAA04 MEDTRONIC AUSTRALASIA PTY LTD $1,800.00
MAA05 MEDTRONIC AUSTRALASIA PTY LTD $529.00
MAA06 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00
MAA07 MEDTRONIC AUSTRALASIA PTY LTD $529.00
MAA09 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00
MAA10 MEDTRONIC AUSTRALASIA PTY LTD $1,800.00
Page 9 of 16
MAA11 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00
MAA12 MEDTRONIC AUSTRALASIA PTY LTD $529.00
MAA02 MEDTRONIC AUSTRALASIA PTY LTD $529.00
MAA08 MEDTRONIC AUSTRALASIA PTY LTD $1,400.00
NBB21 New South Wales Bone Bank $3,759.00
PBT29 Perth Bone and Tissue Bank $2,940.00
QBB33 The Queensland Bone Bank $3,052.00
TBV31 Donor Tissue Bank of Victoria $3,749.00
MVS08 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB24 New South Wales Bone Bank $8,411.00
PBT30 Perth Bone and Tissue Bank $7,000.00
QBB37 The Queensland Bone Bank $4,717.00
TBV32 Donor Tissue Bank of Victoria $8,178.00
NBB22 New South Wales Bone Bank $3,500.00
PBT31 Perth Bone and Tissue Bank $2,000.00
QBB34 The Queensland Bone Bank $2,738.00
TBV33 Donor Tissue Bank of Victoria $3,415.00
NBB23 New South Wales Bone Bank $1,546.00
PBT32 Perth Bone and Tissue Bank $1,500.00
QBB35 The Queensland Bone Bank $1,321.00
TBV34 Donor Tissue Bank of Victoria $1,473.00
QBB36 The Queensland Bone Bank $812.00
TBV37 Donor Tissue Bank of Victoria $2,187.00
NBB26 New South Wales Bone Bank $1,999.00
Page 10 of 16
NBB50 New South Wales Bone Bank $3,998.00
QBB39 The Queensland Bone Bank $1,781.00
NBB51 New South Wales Bone Bank $2,162.00
MVS19 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB25 New South Wales Bone Bank $3,053.00
TBV49 Donor Tissue Bank of Victoria $2,873.00
MVS20 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB29 New South Wales Bone Bank $4,066.00
QBB43 The Queensland Bone Bank $3,354.00
NBB30 New South Wales Bone Bank $4,118.00
PBT33 Perth Bone and Tissue Bank $3,343.00
NBB27 New South Wales Bone Bank $3,583.00
PBT35 Perth Bone and Tissue Bank $2,800.00
TBV36 Donor Tissue Bank of Victoria $3,489.00
NBB28 New South Wales Bone Bank $3,595.00
MVS09 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
PBT34 Perth Bone and Tissue Bank $4,200.00
TBV35 Donor Tissue Bank of Victoria $3,346.00
NBB53 New South Wales Bone Bank $1,874.00
NBB31 New South Wales Bone Bank $2,305.00
TBV38 Donor Tissue Bank of Victoria $2,336.00
PBT47 Perth Bone and Tissue Bank $1,921.00
Page 11 of 16
QBB05 The Queensland Bone Bank $1,547.00
TBV40 Donor Tissue Bank of Victoria $1,640.00
TBV39 Donor Tissue Bank of Victoria $2,763.00
PBT60 Perth Bone and Tissue Bank $2,000.00
QBB47 The Queensland Bone Bank $871.00
TBV41 Donor Tissue Bank of Victoria $1,449.00
PBT40 Perth Bone and Tissue Bank $2,954.00
PBT65 Perth Bone and Tissue Bank $6,300.00
MVS18 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB06 New South Wales Bone Bank $3,913.00
PBT13 Perth Bone and Tissue Bank $1,800.00
QBB15 The Queensland Bone Bank $2,495.00
TBV19 Donor Tissue Bank of Victoria $3,893.00
NBB49 New South Wales Bone Bank $2,399.00
NBB47 New South Wales Bone Bank $3,850.00
MVS21 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $382.00
PBT41 Perth Bone and Tissue Bank $300.00
TBV43 Donor Tissue Bank of Victoria $826.00
AUB07 Australian Biotechnologies $1,854.00
AUB10 Australian Biotechnologies $2,184.00
Page 12 of 16
NBB01 New South Wales Bone Bank $2,487.00
PBT61 Perth Bone and Tissue Bank $1,985.00
QBB62 The Queensland Bone Bank $2,124.00
TBV05 Donor Tissue Bank of Victoria $1,453.00
QBB65 The Queensland Bone Bank $1,584.00
NBB02 New South Wales Bone Bank $2,883.00
PBT01 Perth Bone and Tissue Bank $2,800.00
QBB01 The Queensland Bone Bank $2,124.00
TBV06 Donor Tissue Bank of Victoria $2,691.00
AUB09 Australian Biotechnologies $2,228.00
NBB69 New South Wales Bone Bank $3,530.00
QBB69 The Queensland Bone Bank $2,124.00
QBB59 The Queensland Bone Bank $2,124.00
QBB48 The Queensland Bone Bank $2,271.00
QBB63 The Queensland Bone Bank $1,735.00
PBT02 Perth Bone and Tissue Bank $2,500.00
NBB33 New South Wales Bone Bank $2,778.00
TBV42 Donor Tissue Bank of Victoria $2,763.00
NBB68 New South Wales Bone Bank $3,425.00
Page 13 of 16
NBB72 New South Wales Bone Bank $2,826.00
NBB73 New South Wales Bone Bank $2,826.00
NBB70 New South Wales Bone Bank $2,827.00
QBB70 The Queensland Bone Bank $2,124.00
PBT46 Perth Bone and Tissue Bank $2,800.00
NBB67 New South Wales Bone Bank $2,826.00
QBB58 The Queensland Bone Bank $2,124.00
TBV57 Donor Tissue Bank of Victoria $2,691.00
NBB71 New South Wales Bone Bank $2,826.00
QBB57 The Queensland Bone Bank $2,124.00
TBV47 Donor Tissue Bank of Victoria $2,196.00
MVS17 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
QBB51 The Queensland Bone Bank $2,091.00
TBV48 Donor Tissue Bank of Victoria $2,798.00
NBB35 New South Wales Bone Bank $3,258.00
NBB36 New South Wales Bone Bank $3,301.00
PBT45 Perth Bone and Tissue Bank $2,635.00
QBB54 The Queensland Bone Bank $2,614.00
TBV45 Donor Tissue Bank of Victoria $3,138.00
TBV44 Donor Tissue Bank of Victoria $3,248.00
Page 14 of 16
MVS11 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
QBB08 The Queensland Bone Bank $3,094.00
PBT44 Perth Bone and Tissue Bank $5,000.00
NBB46 New South Wales Bone Bank $5,158.00
NBB45 New South Wales Bone Bank $1,874.00
MVS16 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB37 New South Wales Bone Bank $5,260.00
QBB55 The Queensland Bone Bank $4,694.00
QBB64 The Queensland Bone Bank $4,717.00
NBB44 New South Wales Bone Bank $7,059.00
AUB06 Australian Biotechnologies $2,562.00
QBB53 The Queensland Bone Bank $1,096.00
NBB41 New South Wales Bone Bank $4,849.00
NBB43 New South Wales Bone Bank $3,170.00
NBB42 New South Wales Bone Bank $3,423.00
QBB02 The Queensland Bone Bank $964.00
NBB66 New South Wales Bone Bank $1,563.00
Page 15 of 16
MVS15 Institute of Medical & Veterinary Science T/A South Australian Tissue Bank $2,290.00
NBB07 New South Wales Bone Bank $3,606.00
PBT14 Perth Bone and Tissue Bank $1,500.00
QBB16 The Queensland Bone Bank $2,495.00
TBV20 Donor Tissue Bank of Victoria $3,609.00
NBB40 New South Wales Bone Bank $2,399.00
NBB38 New South Wales Bone Bank $3,170.00
Page 16 of 16
Part C - Other Prostheses February 2016
DF001 DANAIIS Insulin Pump Continuous insulin infusion pump 75mm x 45mm x 19mm $4,000.00
AN011 Animas Vibe Insulin Pump Ambulatory insulin infusion pump 8.26 x 5.08 x 2.18cm $8,950.00
with real-time continuous glucose
monitoring (CGM) capability
DF002 DANAR Insulin Pump The DANAR Insulin Pump is a small 75 x 45 x 19mm, 60grams $8,950.00
device about the size of a pager. It
holds up to 300 units of insulin,
which is delivered continuously
through a small tube to the patient.
The DANAR Insulin Pump also has
an integrated blood glucose meter and
remote control via bluetooth
communication.
RO044 Accu-Chek Combo System Insulin delivery device capable of The Accu-Chek Combo $8,950.00
remotely receiving and acting on System is only available in
information about blood glucose one size.
levels, performing bolus calculation
and bolus advice on additional
parameters than what is normally
RO051 ACCU-CHEK Insight System Insulin delivery device capable of No variable sizes offered. $8,950.00
remotely receiving and acting on Only one system provided.
information about blood glucose
levels, performing bolus calculation
and bolus advice on additional
parameters than what is normally
Page 1 of 4
MC839 Medtronic MiniMed Insulin Paradigm Veo Model MMT-554. 5.1 x 7.6 x 2.0cm $9,500.00
Infusion Pump 'Smart' Insulin Pump with REAL-
Time continuous glucose monitoring
capability, incorporating a low
glucose suspend and with remote
MC840 Medtronic MiniMed Insulin Paradigm Veo Model MMT-754. 5.1 x 9.4 x 2.0cm $9,500.00
Infusion Pump 'Smart' Insulin Pump with REAL-
Time continuous glucose monitoring
capability, incorporating a low
glucose suspend and with remote
MI150 MiniMed 640G Insulin Pump MiniMed 640G Insulin Pump with 1.8ml and 3.0ml $9,500.00
SmartGuard Technology and
continuous glucose monitoring
capability, designed to automatically
suspend insulin delivery before
dangerous lows occur, and
automatically resume after levels
recover.
Page 2 of 4
MC763 Reveal XT Reveal XT Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00
volume of 9cc
MC768 Reveal DX Insertable Cardiac Monitor 61 x 19 x 8 mm with a $3,900.00
volume of 9cc
SJ152 SJM Confirm Model DM2102 Implantable cardiac monitor with 6.5cc, 12g $3,900.00
atrial fibrillation monitoring.
SJ159 SJM Confirm Model DM2100 Implantable cardiac monitor 6.5cc, 12g $3,900.00
BT153 BioMonitor Implantable cardiac monitor for 53.3mm x 42.7mm x 7.1mm, $3,900.00
continuous remote monitoring of 26 grams
patients with Atrial Fibrillation (AF)
or unexplained syncope
MI141 Reveal LINQ Insertable Cardiac Monitor 45 x 7 x 3.5mm, 1.18cc $3,900.00
SJ369 Merlin@Home wireless Home cardiac monitor (RF) with one size $1,960.00
landline, cellular and broadband
connectivity
SJ370 Merlin@Home Inductive Home cardiac monitor (inductive) one size $1,960.00
with landline, cellular and broadband
connectivity
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BT179 Cardio Messenger II-S 3G Bedside/Remote transmitter w/ ICD Bedside Device - 203 x $1,960.00
device life network access to 136mm x 80mm, 450 grams
Biotronik standard home monitoring
data management service.
BS294 Latitude Communicator Remote patient management system for One size only $1,960.00
implanted cardiac devices
MI180 MyCareLink Patient Monitor Electronic cellular patient monitor One size $1,960.00
which gathers and transmits cardiac
information from an implanted cardiac
device (CIED) to your health care
professional for assessment.
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